Collaborative clinical trials: quality or quantity?
Identifieur interne : 001294 ( Istex/Corpus ); précédent : 001293; suivant : 001295Collaborative clinical trials: quality or quantity?
Auteurs : Ian F. TannockSource :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 2001.
English descriptors
- Teeft :
- Adjuvant hysterectomy, Anticancer drugs, Bayesian terms, Better outcome, Biologic, Biologic mechanisms, Breast cancer, Cervical cancer, Chemotherapy, Clin cancer, Clinical scientists, Clinical trial, Clinical trials, Collaborative group, Colorectal cancer, Common tumors, Concurrent chemotherapy, Confocal microscopy, Data torturing, Doxorubicin, Early breast cancer, Early breast cancer trialists, Elsevier science, Endpoint, England journal, High chance, Individual patients, Individual trials, Laboratory science, Large trials, Larger gains, Mechanistic information, Medical oncology, Multiple endpoints, Multiple tests, Natl cancer inst, Normal tissues, Oncology, Other factors, Outcome measures, Pool resources, Positive effect, Positive result, Princess margaret hospital, Radiation therapy, Randomised trials, Randomized, Randomized trial, Randomized trials, Relative merits, Single trial, Small differences, Small randomized trials, Solid tissue, Solid tumors, Standard treatment, Statistical power, Such trials, Therapeutic index, Treatment failure, Trials testing, Tumor biopsies, Tumor cells.
Abstract
Abstract: Purpose: To review the merits of using the limited available resources — patients, money, clinical scientists, and ideas — in various types of clinical trial. Conclusions: Two types of trial represent a poor use of resources: (a) nonrandomized trials that provide no insight into biologic mechanisms and are not precursors to testing new strategies in comparison with standard treatment in randomized trials; and (b) small randomized trials that are difficult to interpret because of a high rate of false-positive and false-negative trials. Very large trials that can detect small differences in survival for patients with common tumors are appropriate, but a similar design to detect transient improvements due to palliative therapy represent a poor use of resources. Larger gains in therapeutic index will require the recognition of tumor heterogeneity and the conduct of small trials that are based on biologic hypotheses, and which provide mechanistic information in patients; two examples are provided. Ultimately, strategies that may be individualized among a group of patients with histologically similar tumors will need to be evaluated against the current standard (and homogeneous) treatment.
Url:
DOI: 10.1016/S0360-3016(00)01500-5
Links to Exploration step
ISTEX:A9EDF66D16AE9C7255E48A6038058063F1F97E23Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Collaborative clinical trials: quality or quantity?</title><author><name sortKey="Tannock, Ian F" sort="Tannock, Ian F" uniqKey="Tannock I" first="Ian F" last="Tannock">Ian F. Tannock</name><affiliation><mods:affiliation>Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: ian.tannock@uhn.on.ca</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A9EDF66D16AE9C7255E48A6038058063F1F97E23</idno><date when="2001" year="2001">2001</date><idno type="doi">10.1016/S0360-3016(00)01500-5</idno><idno type="url">https://api.istex.fr/ark:/67375/6H6-MP66ZR4M-R/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001294</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001294</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Collaborative clinical trials: quality or quantity?</title><author><name sortKey="Tannock, Ian F" sort="Tannock, Ian F" uniqKey="Tannock I" first="Ian F" last="Tannock">Ian F. Tannock</name><affiliation><mods:affiliation>Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: ian.tannock@uhn.on.ca</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="ISSN">0360-3016</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001">2001</date><biblScope unit="volume">49</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="339">339</biblScope><biblScope unit="page" to="343">343</biblScope></imprint><idno type="ISSN">0360-3016</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Adjuvant hysterectomy</term><term>Anticancer drugs</term><term>Bayesian terms</term><term>Better outcome</term><term>Biologic</term><term>Biologic mechanisms</term><term>Breast cancer</term><term>Cervical cancer</term><term>Chemotherapy</term><term>Clin cancer</term><term>Clinical scientists</term><term>Clinical trial</term><term>Clinical trials</term><term>Collaborative group</term><term>Colorectal cancer</term><term>Common tumors</term><term>Concurrent chemotherapy</term><term>Confocal microscopy</term><term>Data torturing</term><term>Doxorubicin</term><term>Early breast cancer</term><term>Early breast cancer trialists</term><term>Elsevier science</term><term>Endpoint</term><term>England journal</term><term>High chance</term><term>Individual patients</term><term>Individual trials</term><term>Laboratory science</term><term>Large trials</term><term>Larger gains</term><term>Mechanistic information</term><term>Medical oncology</term><term>Multiple endpoints</term><term>Multiple tests</term><term>Natl cancer inst</term><term>Normal tissues</term><term>Oncology</term><term>Other factors</term><term>Outcome measures</term><term>Pool resources</term><term>Positive effect</term><term>Positive result</term><term>Princess margaret hospital</term><term>Radiation therapy</term><term>Randomised trials</term><term>Randomized</term><term>Randomized trial</term><term>Randomized trials</term><term>Relative merits</term><term>Single trial</term><term>Small differences</term><term>Small randomized trials</term><term>Solid tissue</term><term>Solid tumors</term><term>Standard treatment</term><term>Statistical power</term><term>Such trials</term><term>Therapeutic index</term><term>Treatment failure</term><term>Trials testing</term><term>Tumor biopsies</term><term>Tumor cells</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Purpose: To review the merits of using the limited available resources — patients, money, clinical scientists, and ideas — in various types of clinical trial. Conclusions: Two types of trial represent a poor use of resources: (a) nonrandomized trials that provide no insight into biologic mechanisms and are not precursors to testing new strategies in comparison with standard treatment in randomized trials; and (b) small randomized trials that are difficult to interpret because of a high rate of false-positive and false-negative trials. Very large trials that can detect small differences in survival for patients with common tumors are appropriate, but a similar design to detect transient improvements due to palliative therapy represent a poor use of resources. Larger gains in therapeutic index will require the recognition of tumor heterogeneity and the conduct of small trials that are based on biologic hypotheses, and which provide mechanistic information in patients; two examples are provided. Ultimately, strategies that may be individualized among a group of patients with histologically similar tumors will need to be evaluated against the current standard (and homogeneous) treatment.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>randomized</json:string><json:string>chemotherapy</json:string><json:string>endpoint</json:string><json:string>oncology</json:string><json:string>doxorubicin</json:string><json:string>clinical trials</json:string><json:string>biologic mechanisms</json:string><json:string>standard treatment</json:string><json:string>cervical cancer</json:string><json:string>therapeutic index</json:string><json:string>such trials</json:string><json:string>biologic</json:string><json:string>large trials</json:string><json:string>randomized trials</json:string><json:string>solid tumors</json:string><json:string>tumor cells</json:string><json:string>better outcome</json:string><json:string>natl cancer inst</json:string><json:string>breast cancer</json:string><json:string>data torturing</json:string><json:string>positive result</json:string><json:string>multiple endpoints</json:string><json:string>single trial</json:string><json:string>colorectal cancer</json:string><json:string>individual trials</json:string><json:string>randomized trial</json:string><json:string>mechanistic information</json:string><json:string>clinical trial</json:string><json:string>england journal</json:string><json:string>other factors</json:string><json:string>statistical power</json:string><json:string>elsevier science</json:string><json:string>high chance</json:string><json:string>clinical scientists</json:string><json:string>pool resources</json:string><json:string>relative merits</json:string><json:string>laboratory science</json:string><json:string>medical oncology</json:string><json:string>outcome measures</json:string><json:string>multiple tests</json:string><json:string>small differences</json:string><json:string>bayesian terms</json:string><json:string>trials testing</json:string><json:string>positive effect</json:string><json:string>individual patients</json:string><json:string>common tumors</json:string><json:string>normal tissues</json:string><json:string>anticancer drugs</json:string><json:string>solid tissue</json:string><json:string>larger gains</json:string><json:string>princess margaret hospital</json:string><json:string>small randomized trials</json:string><json:string>confocal microscopy</json:string><json:string>tumor biopsies</json:string><json:string>radiation therapy</json:string><json:string>treatment failure</json:string><json:string>early breast cancer trialists</json:string><json:string>collaborative group</json:string><json:string>early breast cancer</json:string><json:string>randomised trials</json:string><json:string>adjuvant hysterectomy</json:string><json:string>concurrent chemotherapy</json:string><json:string>clin cancer</json:string></teeft></keywords><author><json:item><name>Ian F Tannock M.D., Ph.D.</name><affiliations><json:string>Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Canada</json:string><json:string>E-mail: ian.tannock@uhn.on.ca</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Keynote lecture</value></json:item></subject><arkIstex>ark:/67375/6H6-MP66ZR4M-R</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Abstract: Purpose: To review the merits of using the limited available resources — patients, money, clinical scientists, and ideas — in various types of clinical trial. Conclusions: Two types of trial represent a poor use of resources: (a) nonrandomized trials that provide no insight into biologic mechanisms and are not precursors to testing new strategies in comparison with standard treatment in randomized trials; and (b) small randomized trials that are difficult to interpret because of a high rate of false-positive and false-negative trials. Very large trials that can detect small differences in survival for patients with common tumors are appropriate, but a similar design to detect transient improvements due to palliative therapy represent a poor use of resources. Larger gains in therapeutic index will require the recognition of tumor heterogeneity and the conduct of small trials that are based on biologic hypotheses, and which provide mechanistic information in patients; two examples are provided. Ultimately, strategies that may be individualized among a group of patients with histologically similar tumors will need to be evaluated against the current standard (and homogeneous) treatment.</abstract><qualityIndicators><score>8.22</score><pdfWordCount>4060</pdfWordCount><pdfCharCount>24535</pdfCharCount><pdfVersion>1.2</pdfVersion><pdfPageCount>5</pdfPageCount><pdfPageSize>586 x 785 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>180</abstractWordCount><abstractCharCount>1212</abstractCharCount><keywordCount>1</keywordCount></qualityIndicators><title>Collaborative clinical trials: quality or quantity?</title><pmid><json:string>11173126</json:string></pmid><pii><json:string>S0360-3016(00)01500-5</json:string></pii><genre><json:string>research-article</json:string></genre><host><title>International Journal of Radiation Oncology, Biology, Physics</title><language><json:string>unknown</json:string></language><publicationDate>2001</publicationDate><issn><json:string>0360-3016</json:string></issn><pii><json:string>S0360-3016(00)X0093-4</json:string></pii><volume>49</volume><issue>2</issue><pages><first>339</first><last>343</last></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2000</json:string><json:string>1992</json:string><json:string>2001</json:string></date><geogName></geogName><orgName><json:string>Elsevier Science Inc</json:string><json:string>Department of Medical Oncology and Hematology</json:string><json:string>Princess Margaret Hospital and University of Toronto, Toronto, Canada Purpose</json:string><json:string>Princess Margaret Hospital and University of Toronto, Toronto, ON</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Publication</json:string><json:string>Ian F. Tannock</json:string></persName><placeName><json:string>Switzerland</json:string><json:string>Lugano</json:string></placeName><ref_url></ref_url><ref_bibl></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/6H6-MP66ZR4M-R</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - radiology, nuclear medicine & medical imaging</json:string><json:string>2 - oncology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - oncology & carcinogenesis</json:string></scienceMetrix><scopus><json:string>1 - Life Sciences</json:string><json:string>2 - Biochemistry, Genetics and Molecular Biology</json:string><json:string>3 - Cancer Research</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Radiology Nuclear Medicine and imaging</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Oncology</json:string><json:string>1 - Physical Sciences</json:string><json:string>2 - Physics and Astronomy</json:string><json:string>3 - Radiation</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2001</publicationDate><copyrightDate>2001</copyrightDate><doi><json:string>10.1016/S0360-3016(00)01500-5</json:string></doi><id>A9EDF66D16AE9C7255E48A6038058063F1F97E23</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/6H6-MP66ZR4M-R/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/6H6-MP66ZR4M-R/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/6H6-MP66ZR4M-R/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Collaborative clinical trials: quality or quantity?</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://scientific-publisher.data.istex.fr">ELSEVIER</publisher><availability><licence><p>©2001 Elsevier Science Inc.</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-HKKZVM7B-M">elsevier</p></availability><date>2001</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note><note type="content">Section title: ICTR 2000</note><note type="content">Table 1: Problems that prevent single arm studies from giving useful information about therapeutic benefit</note><note type="content">Table 2: Factors that can lead to false-positive and false-negative results among randomized trials</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Collaborative clinical trials: quality or quantity?</title><author xml:id="author-0000"><persName><forename type="first">Ian F</forename><surname>Tannock</surname></persName><roleName type="degree">M.D., Ph.D.</roleName><email>ian.tannock@uhn.on.ca</email><note type="biography">Reprint requests to: Dr. Ian F. Tannock, Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, ON M5G 2M9, Canada</note><affiliation>Reprint requests to: Dr. Ian F. Tannock, Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, ON M5G 2M9, Canada</affiliation><affiliation>Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Canada</affiliation></author><idno type="istex">A9EDF66D16AE9C7255E48A6038058063F1F97E23</idno><idno type="ark">ark:/67375/6H6-MP66ZR4M-R</idno><idno type="DOI">10.1016/S0360-3016(00)01500-5</idno><idno type="PII">S0360-3016(00)01500-5</idno></analytic><monogr><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="pISSN">0360-3016</idno><idno type="PII">S0360-3016(00)X0093-4</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001"></date><biblScope unit="volume">49</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="339">339</biblScope><biblScope unit="page" to="343">343</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2001</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Abstract: Purpose: To review the merits of using the limited available resources — patients, money, clinical scientists, and ideas — in various types of clinical trial. Conclusions: Two types of trial represent a poor use of resources: (a) nonrandomized trials that provide no insight into biologic mechanisms and are not precursors to testing new strategies in comparison with standard treatment in randomized trials; and (b) small randomized trials that are difficult to interpret because of a high rate of false-positive and false-negative trials. Very large trials that can detect small differences in survival for patients with common tumors are appropriate, but a similar design to detect transient improvements due to palliative therapy represent a poor use of resources. Larger gains in therapeutic index will require the recognition of tumor heterogeneity and the conduct of small trials that are based on biologic hypotheses, and which provide mechanistic information in patients; two examples are provided. Ultimately, strategies that may be individualized among a group of patients with histologically similar tumors will need to be evaluated against the current standard (and homogeneous) treatment.</p></abstract><textClass><keywords scheme="keyword"><list><head>article-category</head><item><term>Keynote lecture</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2001">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/6H6-MP66ZR4M-R/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: ce:floats; body; tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>ROB</jid><aid>7969</aid><ce:pii>S0360-3016(00)01500-5</ce:pii><ce:doi>10.1016/S0360-3016(00)01500-5</ce:doi><ce:copyright type="full-transfer" year="2001">Elsevier Science Inc.</ce:copyright><ce:doctopics><ce:doctopic><ce:text>Keynote lecture</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:dochead><ce:textfn>ICTR 2000</ce:textfn></ce:dochead><ce:title>Collaborative clinical trials: quality or quantity?</ce:title><ce:presented>Based on the plenary lecture presented at the ICTR 2000 meeting, Lugano, Switzerland, March 2000.</ce:presented><ce:author-group><ce:author><ce:given-name>Ian F</ce:given-name><ce:surname>Tannock</ce:surname><ce:degrees>M.D., Ph.D.</ce:degrees><ce:cross-ref refid="CORR1">*</ce:cross-ref><ce:e-address>ian.tannock@uhn.on.ca</ce:e-address></ce:author><ce:affiliation><ce:textfn>Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Canada</ce:textfn></ce:affiliation><ce:correspondence id="CORR1"><ce:label>*</ce:label><ce:text>Reprint requests to: Dr. Ian F. Tannock, Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, ON M5G 2M9, Canada</ce:text></ce:correspondence></ce:author-group><ce:date-accepted day="31" month="8" year="2000"></ce:date-accepted><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Purpose: To review the merits of using the limited available resources — patients, money, clinical scientists, and ideas — in various types of clinical trial.</ce:simple-para><ce:simple-para>Conclusions: Two types of trial represent a poor use of resources: (a) nonrandomized trials that provide no insight into biologic mechanisms and are not precursors to testing new strategies in comparison with standard treatment in randomized trials; and (b) small randomized trials that are difficult to interpret because of a high rate of false-positive and false-negative trials. Very large trials that can detect small differences in survival for patients with common tumors are appropriate, but a similar design to detect transient improvements due to palliative therapy represent a poor use of resources. Larger gains in therapeutic index will require the recognition of tumor heterogeneity and the conduct of small trials that are based on biologic hypotheses, and which provide mechanistic information in patients; two examples are provided. Ultimately, strategies that may be individualized among a group of patients with histologically similar tumors will need to be evaluated against the current standard (and homogeneous) treatment.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Collaborative clinical trials: quality or quantity?</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Collaborative clinical trials: quality or quantity?</title></titleInfo><name type="personal"><namePart type="given">Ian F</namePart><namePart type="family">Tannock</namePart><namePart type="termsOfAddress">M.D., Ph.D.</namePart><affiliation>Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Canada</affiliation><affiliation>E-mail: ian.tannock@uhn.on.ca</affiliation><description>Reprint requests to: Dr. Ian F. Tannock, Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, ON M5G 2M9, Canada</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">2001</dateIssued><copyrightDate encoding="w3cdtf">2001</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Abstract: Purpose: To review the merits of using the limited available resources — patients, money, clinical scientists, and ideas — in various types of clinical trial. Conclusions: Two types of trial represent a poor use of resources: (a) nonrandomized trials that provide no insight into biologic mechanisms and are not precursors to testing new strategies in comparison with standard treatment in randomized trials; and (b) small randomized trials that are difficult to interpret because of a high rate of false-positive and false-negative trials. Very large trials that can detect small differences in survival for patients with common tumors are appropriate, but a similar design to detect transient improvements due to palliative therapy represent a poor use of resources. Larger gains in therapeutic index will require the recognition of tumor heterogeneity and the conduct of small trials that are based on biologic hypotheses, and which provide mechanistic information in patients; two examples are provided. Ultimately, strategies that may be individualized among a group of patients with histologically similar tumors will need to be evaluated against the current standard (and homogeneous) treatment.</abstract><note type="content">Section title: ICTR 2000</note><note type="content">Table 1: Problems that prevent single arm studies from giving useful information about therapeutic benefit</note><note type="content">Table 2: Factors that can lead to false-positive and false-negative results among randomized trials</note><subject><genre>article-category</genre><topic>Keynote lecture</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Radiation Oncology, Biology, Physics</title></titleInfo><titleInfo type="abbreviated"><title>ROB</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">2001</dateIssued></originInfo><identifier type="ISSN">0360-3016</identifier><identifier type="PII">S0360-3016(00)X0093-4</identifier><part><date>2001</date><detail type="volume"><number>49</number><caption>vol.</caption></detail><detail type="issue"><number>2</number><caption>no.</caption></detail><extent unit="issue-pages"><start>299</start><end>616</end></extent><extent unit="pages"><start>339</start><end>343</end></extent></part></relatedItem><identifier type="istex">A9EDF66D16AE9C7255E48A6038058063F1F97E23</identifier><identifier type="ark">ark:/67375/6H6-MP66ZR4M-R</identifier><identifier type="DOI">10.1016/S0360-3016(00)01500-5</identifier><identifier type="PII">S0360-3016(00)01500-5</identifier><accessCondition type="use and reproduction" contentType="copyright">©2001 Elsevier Science Inc.</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-HKKZVM7B-M">elsevier</recordContentSource><recordOrigin>Elsevier Science Inc., ©2001</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/6H6-MP66ZR4M-R/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/ChloroquineV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001294 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 001294 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= ChloroquineV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:A9EDF66D16AE9C7255E48A6038058063F1F97E23
|texte= Collaborative clinical trials: quality or quantity?
}}
| This area was generated with Dilib version V0.6.33. |  |