Points in Summary:
1. Why we need to redraw the battle plan—one that focuses on turning the treatment system into a research and learning system that can teach oncologists the best use of the weapons they already have
2. drug and biotechnology industries are lavishing increased attention on cancer (861 drugs and vaccines in clinical trials, according to a recent announcement) most of the newly approved agents that squeeze through the pipeline extend the lives of patients for only a few weeks or months, often at great expense. The outcomes are never gathered. The data is never analyzed. the findings are never disseminated
3. As these patients’ cancers advance, their physicians try regimens they read about in journals or hear about from colleagues. The outcomes are never gathered. The data is never analyzed. And the findings are never disseminated.
4. an estimated 70 percent of all cancer drugs are used off-label. In other words, most prescribed chemotherapy regimens have not been approved by the Food and Drug Administration for that particular use. Much of the off-label use is supported by the slimmest of evidence, often just a single trial in the medical literature of limited size and duration.
5. Pediatric oncologists on the other hand, steadily refine the treatment regimens base don their success in using shared data and results in trials to the point where survival rates today are over 80 percent, up from 20 percent in the 1960s. Adult tumors can take decades to develop and are resistant to treatment. Pediatric cancers, in contrast, usually “arise from embryonic development and develop into cancers that are much more susceptible to chemotherapy and radiation
6. Focus on collecting extensive information about the 1.3 million Americans who are diagnosed and treated for cancer every year. Let nation’s physicians move toward adopting electronic medical records. This will enable oncologists to record their patients’ demographic and genetic information their diagnoses, their treatments, and, eventually, their outcomes. This information could then be analyzed retrospectively to see what works and translated into guidelines for better care if the data is in the database, you can answer that question in a few hours, or maybe even a few minutes .
7. The National Cancer Institute recently took a major step in building an information superhighway to serve a cancer learning network. The ambitious goal behind CaBIG, the Cancer Biomedical Infomatics Grid, is nothing less than turning the billions the nation spends each year on cancer care into that “learning system