Position paper: new insights into the immunobiology and dynamics of tumor-host interactions require adaptations of clinical studies

Expert Rev Anticancer Ther. 2020 Aug;20(8):639-646. doi: 10.1080/14737140.2020.1785874. Epub 2020 Jun 30.

Abstract

Introduction: Prospective double-blind placebo-controlled randomized clinical trials (RCTs) are considered standard for the proof of the efficacy of oncologic therapies. Molecular methods have provided new insights into tumor biology and led to the development of targeted therapies. Due to the increasing complexity of molecular tumor characteristics and of the individuality of specific anti-tumor immune reactivity, RCTs are unfortunately only of limited use.

Areas covered: The historical methods of drug research and approval and the related practices of reimbursement by statutory and private health insurance companies are being questioned. New, innovative methods for the documentation of evidence in personalized medicine will be addressed. Possible perspectives and new approaches are discussed, in particular with regard to glioblastoma.

Expert opinion: Highly specialized translational oncology groups like the IOZK can contribute to medical progress and quick transfer 'from bench to bedside.' Their contribution should be acknowledged and taken into account more strongly in the development of guidelines and the reimbursement of therapy costs. Methodological plurality should be encouraged.

Keywords: Cancer immunotherapy; conflict of interest; dendritic Cells; evidence-based medicine; guidelines; newcastle Disease Virus; randomized trials; tumor immunology.

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Glioblastoma / immunology
  • Glioblastoma / pathology
  • Glioblastoma / therapy
  • Guidelines as Topic
  • Humans
  • Molecular Targeted Therapy*
  • Neoplasms / immunology
  • Neoplasms / pathology*
  • Neoplasms / therapy
  • Precision Medicine / methods
  • Randomized Controlled Trials as Topic / methods*
  • Reimbursement Mechanisms
  • Translational Research, Biomedical / organization & administration

Substances

  • Antineoplastic Agents