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Go Small or Go Big?

Researchers are torn over the need for large clinical trials, the Wall Street Journal reports.

It says that some are drawn to smaller trials that rely on, for instance, genetic markers to identify patients who might be the best fit for a particular treatment. As therapies become more and more personalized, Ursula Matulonis from the Dana-Farber Cancer Institute notes there just won't be enough patients with the particular genetic profile to run a large trial. Smaller ones, the Journal adds, are nimbler and faster — and Matulonis says her patients need treatments now.

But others argue that smaller trials will only pick up the "miracle" drugs and that larger trials are needed to provide clinicians with high-quality evidence, the Journal adds. Curtis Meinert from the Johns Hopkins Bloomberg School of Public Health tells it that data generated by National Institutes of Health-funded studies "is very reliable."

The Journal notes that the debate is coming to a head as results from the TAILORx trial are to be announced at the American Society of Clinical Oncology annual meeting. It adds that Steven Shak from Genomic Health, which makes the OncotypeDx test used in the study, says small trials are needed for developing new technologies, but that large trials are needed to show they really work