In this Book

buy this book Buy This Book in Print
summary
How hype, money, and bias can mislead the public into thinking that many worthless or unproven treatments are effective.Each week, people read about new and exciting cancer drugs. Some of these drugs are truly transformative, offering major improvements in how long patients live or how they feel—but what is often missing from the popular narrative is that, far too often, these new drugs have marginal or minimal benefits. Some are even harmful. In Malignant, hematologist-oncologist Dr. Vinayak K. Prasad writes about the many sobering examples of how patients are too often failed by cancer policy and by how oncology is practiced. Throughout this work, Prasad illuminates deceptive practices which• promote novel cancer therapies long before credible data are available to support such treatment; and• exaggerate the potential benefits of new therapies, many of which cost thousands and in some cases hundreds of thousands of dollars.Prasad then critiques the financial conflicts of interest that pervade the oncology field, the pharmaceutical industry, and the US Food and Drug administration. This is a book about how the actions of human beings—our policies, our standards of evidence, and our drug regulation—incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices. Prasad takes us through how cancer trials are conducted, how drugs come to market, and how pricing decisions are made, asking how we can ensure that more cancer drugs deliver both greater benefit and a lower price. Ultimately, Prasad says, • more cancer clinical trials should measure outcomes that actually matter to people with cancer;• patients on those trials should look more like actual global citizens;• we need drug regulators to raise, not perpetually lower, the bar for approval; and• we need unbiased patient advocates and experts.This well-written, opinionated, and engaging book explains what we can do differently to make serious and sustained progress against cancer—and how we can avoid repeating the policy and practice mistakes of the past.

Table of Contents

restricted access Download Full Book
  1. Cover
  2. restricted access
    • Download PDF Download
  1. Title Page, Copyright, Dedication
  2. pp. i-vi
  3. restricted access
    • Download PDF Download
  1. Contents
  2. pp. vii-viii
  3. restricted access
    • Download PDF Download
  1. Acknowledgments
  2. pp. ix-xii
  3. restricted access
    • Download PDF Download
  1. Introduction
  2. pp. 1-8
  3. restricted access
    • Download PDF Download
  1. Part I Cancer Drugs: The Outcomes They Improve and at What Price
  1. 1 The Basics of Cancer Drugs: Cost, Benefit, Value
  2. pp. 11-22
  3. restricted access
    • Download PDF Download
  1. 2 Surrogate Endpoints in Cancer: What Are They and Where Are They Used?
  2. pp. 23-36
  3. restricted access
    • Download PDF Download
  1. 3 The Use and Misuse of Surrogate Endpoints for Drug Approvals
  2. pp. 37-51
  3. restricted access
    • Download PDF Download
  1. 4 How High Prices Harm Patients and Society
  2. pp. 52-64
  3. restricted access
    • Download PDF Download
  1. Part II Societal Forces That Distort Cancer Medicine
  1. 5 Hype, Spin, and the Unbridled Enthusiasm That Distorts Cancer Medicine
  2. pp. 67-77
  3. restricted access
    • Download PDF Download
  1. 6 Financial Conflict of Interest
  2. pp. 78-90
  3. restricted access
    • Download PDF Download
  1. 7 The Harms of Financial Conflicts and How to Rehabilitate Medicine
  2. pp. 91-104
  3. restricted access
    • Download PDF Download
  1. 8 Will Precision Oncology Save Us?
  2. pp. 105-114
  3. restricted access
    • Download PDF Download
  1. Part III How to Interpret Cancer Evidence and Trials
  1. 9 Study Design 201
  2. pp. 117-135
  3. restricted access
    • Download PDF Download
  1. 10 Principles of Oncology Practice
  2. pp. 136-148
  3. restricted access
    • Download PDF Download
  1. 11 Important Trials in Oncology
  2. pp. 149-165
  3. restricted access
    • Download PDF Download
  1. 12 Global Oncology
  2. pp. 166-180
  3. restricted access
    • Download PDF Download
  1. Part IV Solutions
  1. 13 How Should Cancer Drug Development Proceed
  2. pp. 183-200
  3. restricted access
    • Download PDF Download
  1. 14 What Can Three Federal Agencies Do Tomorrow?
  2. pp. 201-220
  3. restricted access
    • Download PDF Download
  1. 15 What Can People with Cancer Do?
  2. pp. 221-230
  3. restricted access
    • Download PDF Download
  1. 16 What Can Students, Residents, and Fellows
  2. pp. 231-238
  3. restricted access
    • Download PDF Download
  1. Epilogue: The Hallmarks of Successful Cancer Policy
  2. pp. 239-246
  3. restricted access
    • Download PDF Download
  1. Glossary
  2. pp. 247-252
  3. restricted access
    • Download PDF Download
  1. References
  2. pp. 253-280
  3. restricted access
    • Download PDF Download
  1. Index
  2. pp. 281-291
  3. restricted access
    • Download PDF Download
Back To Top

This website uses cookies to ensure you get the best experience on our website. Without cookies your experience may not be seamless.