Ludwig Wolf-Dieter, Schildmann Jan
Klinik für Hämatologie, Onkologie und Tumorimmunologie, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
Onkologie. 2011;34 Suppl 1:6-10. doi: 10.1159/000323064. Epub 2011 Jan 17.
Innovations in the drug treatment of cancer patients pose several medical and ethical challenges. The increasing incidence and prevalence of cancer, in combination with the availability of new and usually highly expensive anticancer drugs, are associated with a significant increase in the general costs for the treatment of cancer patients. Therefore, the development of scientific strategies for judgments on benefits is indispensable. In this paper, the authors analyze the benefit assessment and the benefit-risk assessment as a foundation for decisions on prioritization in hematology and oncology. In a first step, regulatory aspects and shortcomings regarding the design of clinical trials in oncology before and after approval of anticancer drugs are identified as factors that contribute to difficulties in establishing the effectiveness of new drugs entering the health care market. The authors will conclude with suggestions for the improvement of benefit-risk analyses and the generation of scientific data necessary for such analyses.
癌症患者药物治疗的创新带来了若干医学和伦理挑战。癌症发病率和患病率不断上升,再加上新型且通常价格高昂的抗癌药物可供使用,这使得癌症患者的总体治疗费用大幅增加。因此,制定科学的效益判断策略必不可少。在本文中,作者分析了效益评估以及效益-风险评估,以此作为血液学和肿瘤学中优先排序决策的基础。第一步,确定抗癌药物获批前后肿瘤学临床试验设计的监管方面及不足之处,这些因素导致难以确定进入医疗保健市场的新药的有效性。作者将以改进效益-风险分析以及生成此类分析所需科学数据的建议作为结论。