Medical ethics articles within Nature Reviews Clinical Oncology

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  • News & Views |

    A recent report from the ATLAS trial comparing different maintenance strategies following haematopoeitic stem cell transplantation for multiple myeloma provides an opportunity to explore various themes of critical appraisal, including end points, the equipoise of trial design, and the part censoring can play in the validity of results.

    • Ghulam Rehman Mohyuddin
    •  & Tomer Meirson

  • Comment |

    The FDA has demonstrated a willingness to expedite access to new cancer medicines by using real-world evidence to support regulatory drug approval. In this article, we explore three recent examples of such approvals and the lessons that can be learned from this collective experience.

    • Michael J. Raphael
    • , Bishal Gyawali
    •  & Christopher M. Booth

  • Comment |

    Shortages of drugs, including chemotherapeutics, are increasingly common in the USA, and compromise patient care, delay clinical trials and are associated with substantial financial costs. The recent shortage of vincristine, a chemotherapeutic used for most children with cancer and countless adult patients, presents a particularly vexing challenge. Drug shortages can cause patients unnecessary anxiety and challenge clinicians to ration lifesaving medications for which no alternative agent exists. We provide an overview of this problem and discuss potential solutions.

    • Erin R. Fox
    •  & Yoram Unguru

  • Editorial |

    Phase I trials form the foundations of evidence-based oncology. Here, we explore the ethical controversies surrounding how participation in such trials should be presented to patients.

  • Comment |

    Many argue that phase I cancer trials are a therapeutic option for eligible patients. I question this position and offer a more nuanced view that differentiates between types of trials. Patients seeking treatment might legitimately pursue phase I trials, although labelling all phase I trials as therapeutic contradicts the spirit of evidence-based medicine.

    • Jonathan Kimmelman

  • Comment |

    Does a patient with advanced incurable disease have a right not to hear the bad news? We think not. Failing to disclose a poor prognosis undermines patient autonomy and increases the likelihood of poor end-of-life care.

    • Devan Stahl
    •  & Tom Tomlinson

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