IT STARTED with Iressa 鈥� a cancer drug cast aside because it didn鈥檛 seem to work. Later it was resurrected when it was found to be effective in lung-cancer patients who carried a particular gene mutation. On page 8 we report that methotrexate, an ancient chemotherapy drug, might be effective when used in a genetically defined subset of patients with colorectal and endometrial cancers. Another study suggests that drugs now used to combat metastasis in patients with advanced cancer might slow the growth of all tumours, if used early. Clinical trials fail to pick up these effects because the patients recruited into them are usually in the late stages of cancer, and their genetic make-up is unknown. The design of these trials needs to catch up with the science. Otherwise yet more lifesaving drugs may fall by the wayside.
Old-style trials will miss lifesaving drugs
Clinical trials are missing niche therapies because people recruited into them are in late stages of cancer and their genetic makeup is unknown