The needed change in the “war on cancer” will not be on the types of expensive drugs being developed, but on the understanding of all the drugs we already have. The system is “overloaded” with drugs (hundreds of them) and “underloaded” with the wisdom and expertise for using them.

As the increasing numbers and types of anti-cancer drugs are developed, oncologists become more and more likely to misuse them in their practices. There is seldom a “standard” therapy which has been proven to be superior to any other therapy. When all studies are compared by meta-analysis, there is no difference. What may work for one, may not work for another. Few drugs work the way we think and few physicians/scientists take the time to think through what it is they are using them for.

The new “targeted” therapeutics have been providing mostly smaller benefits to patients than the conventional cytotoxic agents. Chemotherapy is recommended according to guidelines generated by statistical data. According to the FDA, the response rate of a patient that follows these guidelines is approximately 20%. According to NCI, those who benefit substantially from “targeted” drugs is approximately 10-20%.

These “smart” drugs do not work for everyone, and a system to determine the efficacy of these drugs in a patient is the first crucial step in “personalizing” treatment to the individual. It is highly desirable to know what drugs are effective against “your” particular cancer cells before these toxic agents are systemically administered into your body. Having a good tumor-drug match not only would improve survival rates, it would be cost-effective.

With today’s “cookie-cutter” approach to chemotherapy, we have no idea which cancer patients will benefit from a course of treatment, you don’t know in advance who is going to respond. It is time to explore other avenues of research for cancer treatment.

Physicians are confronted on nearly a daily basis by decisions that have not been addressed by randomized clinical trial evaluation. The number of possible treatment options supported by completed randomized clinical trials becomes increasingly vague for guiding physicians. More and more clinical trials have not produced more clear-cut guidance but more confusion.