ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2014
Oral anticancer drugs: how limited dosing options and dose reductions may affect outcomes in comparative trials and efficacy in patients.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Tivozanib in renal cell carcinoma: a systematic review of the evidence and its dissemination in the scientific literature.BMC cancer · 2022Pooled it
- Tyrosine kinase inhibitors directed against the vascular endothelial growth factor receptor (VEGFR) have distinct cutaneous toxicity profiles: a meta-analysis and review of the literature.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015Pooled it
- A phase I/II trial evaluating the safety of increased-dose S- 1 with oxaliplatin and nivolumab in HER2-negative advanced gastric cancer.BMC cancer · 2025Trial
- Proof of Concept of a Mobile Health Short Message Service Text Message Intervention That Promotes Adherence to Oral Anticancer Agent Medications: A Randomized Controlled Trial.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2016Trial
- Hand-foot skin reaction associated with vascular endothelial growth factor receptor tyrosine kinase inhibitors: a FAERS-based pharmacovigilance study.Frontiers in medicine · 2026Article
- The Impact of Exuberance on Equipoise in Oncology Clinical Trials: Sotorasib as Archetype.The oncologist · 2024Article
- Magnitude of effect and sample size justification in trials supporting anti-cancer drug approval by the US Food and Drug Administration.Scientific reports · 2024Article
- Alectinib for treating patients with metastaticLung cancer management · 2023Review
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- Association of Adjuvant or Metastatic Setting With Discontinuation of Cancer Drugs in Clinical Trials.JAMA network open · 2022Article
- Case Report: Durable Response to Very Low Dose Tyrosine Kinase Inhibitors in Advanced Hepatocellular Carcinoma.Frontiers in oncology · 2021Article
- The impact of pricing strategy on the costs of oral anti-cancer drugs.Cancer medicine · 2019Article
- Cancer drug development: The missing links.Experimental biology and medicine (Maywood, N.J.) · 2019Review
- Results of weekday-on and weekend-off administration schedule of sunitinib therapy for advanced renal cell carcinoma.International journal of clinical oncology · 2019Article
- Management of adverse events associated with bosutinib treatment of chronic-phase chronic myeloid leukemia: expert panel review.Journal of hematology & oncology · 2018Review
- Dosing Patterns and Economic Burden of Palbociclib Drug Wastage in HR+/HER2- Metastatic Breast Cancer.Advances in therapy · 2018Article
- Pharmacodynamic and Pharmacokinetic Markers For Anti-angiogenic Cancer Therapy: Implications for Dosing and Selection of Patients.European journal of drug metabolism and pharmacokinetics · 2018Review
- Health policy: Me-too drugs with limited benefits - the tale of regorafenib for HCC.Nature reviews. Clinical oncology · 2017Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Historically, cancer medicine has avoided the problem of unequal dosing by comparing maximum-tolerated doses of intravenous regimens with proportionate dose reductions for toxicity. However, in recent years, with the development of numerous oral anticancer agents, dosing options are arbitrarily and increasingly limited by the size of pills. We contend that an underappreciated consequence of pill size is unequal dosing in comparative clinical trials and that this can have an impact on outcomes. We discuss how comparative effectiveness trials can be unbalanced and how the use of doses that are not sustainable might affect outcomes, especially marginal ones. We further argue that because of their poor tolerability and their limited dosing options, which often result in large dose adjustments in response to toxicity, the real-world clinical effectiveness of oral anticancer agents may be diminished and may not emulate results achieved in registration trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.