In JAMA this week, the University of California, San Francisco's Laura Esserman and FDA's Janet Woodcock discuss the identification of investigational cancer drugs. Currently, how cancer medications are developed is inefficient, expensive, and more often than not results in drugs that don't account for cancer's heterogeneic nature, Esserman and Woodcock write. What's needed, they add, is a model of collaboration instead of competition, and new clinical trial designs that take cancer's heterogeneity and complexity into account. "An approach to improving the ability to more rapidly identify new drugs for the targeted treatment of diseases such as cancer involves focusing on subtypes of patients who at the time of diagnosis are at risk for a poor outcome but who do not yet have metastatic disease," Esserman and Woodcock write. "This approach will require and enable the identification of patient populations using defined prognostic and predictive biomarkers. Precompetitive collaboration could help facilitate the sharing of information."
Also in JAMA this week, the journal's Anita Slomski reports that the US Preventive Services Task Force's recent recommendation that no man receive PSA-based screening for prostate cancer was both welcomed by primary care physicians and derided by urologists. Physicians tell Slomski that the USPSTF's guidelines will allow them to concentrate on their patient's more pressing health problems, leaving a discussion of prostate cancer for those patients who have concerns or a family history of the disease. But urologists say PSA screening keeps the death rate related to prostate cancer down, and that widespread screening should continue.