Thursday 12 April 2012

Standards in Cancer Research

As regular readers of this blog will know, I believe that the relative lack of clinical success arising from cancer research is a major issue that demands attention from patients, patient advocates and the research community alike. In a recent post I pointed out that:

The truth is that there is an awful lot of money invested in cancer research - there are billions of dollars of funding from governments, private foundations, the drugs industry and members of the public donating to the cancer research charities. If it was just a matter of money the fight would have been won by now – or at least be further along than we currently are.

If it's not just a question of funding, then how can we explain why new treatments are so slow in coming? And why are the new treatments that do appear so often disappointing?

Interestingly enough a new article in the journal Nature (considered one of the world's leading scientific journals), casts an eye over the cancer research landscape and comes up with some depressing findings. What the authors find is that much pre-clinical research (i.e. research aimed at therapeutic outcomes rather than theoretical understanding) is pretty much a waste of time. While the papers may generate other papers and research (and gain the authors much prestige and funding), when it comes to reproducing the results in other laboratories or by other researchers there is nothing there. In fact a drug company, Amgen, attempted to reproduce the results from a number of 'landmark' cancer research papers and only manage to succeed in 11% of them.

Why is this? One of the reasons they highlight is similar to the one I have also discussed:

They include the use of small numbers of poorly characterized tumour cell lines that inadequately recapitulate human disease, an inability to capture the human tumour environment, a poor appreciation of pharmacokinetics and pharmacodynamics, and the use of problematic endpoints and testing strategies.

And, also echoing a point I have made previously on this blog:

What reasons underlie the publication of erroneous, selective or irreproducible data? The academic system and peer-review process tolerates and perhaps even inadvertently encourages such conduct. To obtain funding, a job, promotion or tenure, researchers need a strong publication record, often including a first-authored high-impact publication.

If this isn't a major scandal than what is? There are many anti-cancer activists now campaigning on trivia like plain packaging for tobacco when the real campaign needs to be focused on things like this. We should be demanding more from researchers, from academia and from the medical profession - not arguing over what colour wrapping we should have on cigarettes.

I'll leave the final words to C. Glenn Begley and Lee M. Ellis, authors of the article in Nature:

We in the field must remain focused on the purpose of cancer research: to improve the lives of patients. Success in our own careers should be a consequence of outstanding research that has an impact on patients.

Cancer researchers are funded by community taxes and by the hard work and philanthropic donations of advocates. More importantly, patients rely on us to embrace innovation, make advances and deliver new therapies that will improve their lives. Although hundreds of thousands of research papers are published annually, too few clinical successes have been produced given the public investment of significant financial resources.

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