Joan
That you for the url link on Vogl's piece. He told Medscape Oncology that the data on Kadcyla (T-DM1) are not as clear as they should be. The study's control regimen (Tykerb and Xeloda) was "distinctly suboptimal" and not a standard of care, even though it is an FDA-approved treatment option in this setting. The 5.8 month difference in overall survival in the two study groups might have been inflated by this control regimen. He would have preferred to see the control patients also receive Herceptin, which he believes to be a necessary complement to Tykerb.
He went on to say that Kadcyla (T-DM1) does not meet the goals of a major advance, explaining that such an advance, in his opinion, must cure some patients, increase the rate of clinical complete remission, or produce a high rate of very long partial response.
This all should remind physicians that it is the good outcome of the patient not the therapy applied that constitute successful application of the healing arts. We must remember that the best medical care is not always the most expensive. We can still hope for a good outcome if you use all the available drugs at our disposal that best meet the needs of the patient.
http://cancerfocus.org/forum/showthread.php?t=3768