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Drugs that lack single-agent activity: are they worth pursuing in combination?

Nature Reviews Clinical Oncology volume 14, pages 193194 (2017) | Download Citation

Over the past decade, many anticancer drugs have been approved for use only in combination regimens and only in palliative settings, despite having negligible single-agent activity in the same disease. We examine whether these agents provide any tangible clinical benefits and are worthy of continued development, or whether R&D efforts would be better focused elsewhere.

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References

  1. 1.

    et al. A phase 1, multicenter, open-label, dose escalation study of elotuzumab in patients with advanced multiple myeloma. Blood 120, 552–559 (2012).

  2. 2.

    et al. Phase II trial of the pan-deacetylase inhibitor panobinostat as a single agent in advanced relapsed/refractory multiple myeloma. Leuk. Lymphoma. 53, 1820–1823 (2012).

  3. 3.

    et al. Single-agent lapatinib for HER2-overexpressing advanced or metastatic breast cancer that progressed on first- or second-line trastuzumab-containing regimens. Ann. Oncol. 20, 1026–1031 (2009).

  4. 4.

    , , , & Addition of bevacizumab to chemotherapy for treatment of solid tumors: similar results but different conclusions. J. Clin. Oncol. 29, 254–256 (2011).

  5. 5.

    et al. Phase III trial of doxorubicin, paclitaxel, and the combination of doxorubicin and paclitaxel as front-line chemotherapy for metastatic breast cancer: an intergroup trial (E1193). J. Clin. Oncol. 21, 588–592 (2003).

  6. 6.

    & Same data; different interpretations. J. Clin. Oncol. 34, 3729–3732 (2016).

  7. 7.

    ODAC votes against panobinostat in multiple myeloma. OncLive (2014).

  8. 8.

    et al. Vorinostat or placebo in combination with bortezomib in patients with multiple myeloma (VANTAGE 088): a multicentre, randomised, double-blind study. Lancet Oncol. 14, 1129–1140 (2013).

  9. 9.

    et al. Final overall survival results of a randomized trial comparing bortezomib plus pegylated liposomal doxorubicin with bortezomib alone in patients with relapsed or refractory multiple myeloma. Cancer 122, 2050–2056 (2016).

Download references

Author information

Affiliations

  1. Department of Haemato-Oncology, Nobel Hospital, Sinamangal, Kathmandu 21034, Nepal.

    • Bishal Gyawali
  2. Division of Hematology Oncology, Knight Cancer Institute, Oregon Health and Sciences University (OHSU), 3181 South West Sam Jackson Park Road, Portland, Oregon 97239–3098, USA.

    • Vinay Prasad
  3. Department of Public Health and Preventive Medicine, OSHU, 3181 South West Sam Jackson Park Road, Portland, Oregon 97239–3098, USA.

    • Vinay Prasad
  4. Center for Ethics in Health Care, OHSU, 3181 South West Sam Jackson Park Road, Portland, Oregon 97239–3098, USA.

    • Vinay Prasad

Authors

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Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Vinay Prasad.

Supplementary information

Word documents

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    Supplementary information S1 (table)

    Approvals of drugs with limited evidence of single-agent activity as combination therapies

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DOI

https://doi.org/10.1038/nrclinonc.2017.27

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