Equipoise and the technology curve

Simpson, A. H. R. W.; Murray, Iain R.; Duckworth, Andrew D.

doi:10.1302/2046-3758.510.2000655

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…The need for justification with systematic prospective quantification and assessment of the clinical benefit of any novel technique is an ongoing debate (86). One contradiction is evidenced by the fact that such trials are often difficult to implement and require a significant number of patients and a long follow-up because the sensitivity and specificity of the clinical outcome are usually low for detecting quality improvements arising from incremental gains, while opponents claim that the obviousness of the gain makes all randomization unethical (87).…”

Section: Anticipated Technical Developments In Clinical Trial Designsmentioning

confidence: 99%

Methodological Development of Combination Drug and Radiotherapy in Basic and Clinical Research

Chargari

Lévy

Paolettí

et al. 2020

Clinical Cancer Research

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◥Newer technical improvements in radiation oncology have been rapidly implemented in recent decades, allowing an improved therapeutic ratio. The development of strategies using local and systemic treatments concurrently, mainly targeted therapies, has however plateaued. Targeted molecular compounds and immunotherapy are increasingly being incorporated as the new standard of care for a wide array of cancers. A better understanding of possible prior methodology issues is therefore required and should be integrated into upcoming early clinical trials including individualized radiotherapy-drug combinations. The outcome of clinical trials is influenced by the validity of the preclinical proofs of concept, the impact on normal tissue, the robustness of biomarkers and the quality of the delivery of radiation. Herein, key methodological aspects are discussed with the aim of optimizing the design and implementation of future precision drug-radiotherapy trials. Screening Appropriate AssociationsData from in vitro or in vivo experiments suggested a potential for clinical benefit for a very high number of molecular targeted agents in the field of radiotherapy, but this is contrasted by the fact that during the last 15 years, very few new drugs have been approved for

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Section: Anticipated Technical Developments In Clinical Trial Designsmentioning

confidence: 99%