Even More on the Merging of Medical Methods

Part 3: PM and CER go hand in hand


Francis Collins, MD, PhD, Director of the NIH, gave an example of a CER trial that helped researchers understand PM information and identify the best treatment for patients.

A clinical trial was conducted comparing chemotherapy to the drug gefitinib (Iressa) in patients with lung cancer. Gefitinib is a drug that specifically blocks the functioning of EGFR, a molecule important in cell growth. Some lung cancer patients have a mutation that affects EGFR, which can cause cells to grow uncontrollably, leading to cancer.

In this trial, it was found that gefitinib was more effective than chemotherapy in a subset of lung cancer patients — the ones who have a mutation in the gene for EGFR - but not in patients who do not have a mutation in EGFR.

Without CER, researchers might have thought that gefitinib was not effective in the overall population, when in fact some patients do much better with it. Now patients with a mutation in the gene encoding EGFR can be prescribed gefitinib instead of chemotherapy.

Rather than opposing each other, CER and PM should be used hand-in-hand to identify the best therapy for each patient.