Neoplasms: 21

This is the 21st blog in a series of blogs on neoplasia.

Time is not on our side in the war on cancer. Modern clinical trials are long and expensive. The process of testing a prospective new drug can take many years. In the realm of cancer trials, the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO, NIH/NCI trial NO1 CN25512) serves as an example. The PLCO is a randomized controlled cancer trial. Between 1992, when the trial opened, and 2001, when enrollment ended, 155,000 women and men between the ages of 55 and 74 joined PLCO. Screening of participants and the collection of follow-up data will end around 2016. The purpose of the study is to determine if screening will reduce mortality from these cancers. We will need 24 years to answer this question.

Though prospective trials are often considered the only way of determining the efficacy and safety of new treatments, and diagnostic tests, the public may legitimately ask whether society has the time, money and patience for these studies. Those engaged in clinical trials may well ask themselves whether some clinical trials be replaced by new, innovative models producing clinically sound results in less time and for less money?

There are literally thousands of different neoplasms of man, all requiring stage-stratified clinical trials to find effective treatments. Can we go on the way we have in the past? Do we, as a society, have the time or money, to test all of the potential chemotherapeutic agents (most of which will be ineffective) on all of these cancers?

In the next blogs, we'll consider these questions and discuss possible alternative approaches.

-Copyright (C) 2008 Jules J. Berman

key words: cancer, tumor, tumour, carcinogen, neoplasia, neoplastic development, classification, biomedical informatics, tumor development, precancer, benign tumor, ontology, classification, developmental lineage classification and taxonomy of neoplasms