Unconventional anticancer agents: A systematic review of clinical trials Journal Article
| Authors: | Vickers, A. J.; Kuo, J.; Cassileth, B. R. |
| Article Title: | Unconventional anticancer agents: A systematic review of clinical trials |
| Abstract: | Purpose: A substantial number of cancer patients turn to treatments other than those recommended by mainstream oncologists in an effort to sustain tumor remission or halt the spread of cancer. These unconventional approaches include botanicals, high-dose nutritional supplementation, off-label pharmaceuticals, and animal products. The objective of this study was to review systematically the methodologies applied in clinical trials of unconventional treatments specifically for cancer. Methods: MEDLINE 1966 to 2005 was searched using approximately 200 different medical subject heading terms (eg, alternative medicine) and free text words (eg, laetrile). We sought prospective clinical trials of unconventional treatments in cancer patients, excluding studies with only symptom control or nonclinical (eg, immune) end points. Trial data were extracted by two reviewers using a standardized protocol. Results: We identified 14,735 articles, of which 214, describing 198 different clinical trials, were included. Twenty trials were phase I, three were phase I and II, 70 were phase II, and 105 were phase III. Approximately half of the trials investigated fungal products, 20% investigated other botanicals, 10% investigated vitamins and supplements, and 10% investigated off-label pharmaceuticals. Only eight of the phase I trials were dose-finding trials, and a mere 20% of phase II trials reported a statistical design. Of the 27 different agents tested in phase III, only one agent had a prior dose-finding trial, and only for three agents was the definitive study initiated after the publication of phase II data. Conclusion: Unconventional cancer treatments have not been subject to appropriate early-phase trial development. Future research on unconventional therapies should involve dose-finding and phase II studies to determine the suitability of definitive trials. © 2006 by American Society of Clinical Oncology. |
| Keywords: | cancer survival; clinical trial; review; cancer growth; antineoplastic agents; cancer patient; antineoplastic agent; neoplasm; neoplasms; phase 2 clinical trial; publication; dimethyl sulfoxide; systematic review; medline; medical literature; alternative medicine; laetrile; phase 3 clinical trial; phase 1 clinical trial; clinical trials; arginine; curcumin; green tea extract; krestin; viscum album extract; melatonin; clinical trials, phase ii; clinical trials, phase iii; clinical trials, phase i; hydrazine sulfate; ae 941; lentinan |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 24 |
| Issue: | 1 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2006-01-01 |
| Start Page: | 136 |
| End Page: | 140 |
| Language: | English |
| DOI: | 10.1200/jco.2005.03.8406 |
| PUBMED: | 16382123 |
| PROVIDER: | scopus |
| PMCID: | PMC1472241 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 15" - "Export Date: 4 June 2012" - "CODEN: JCOND" - "Source: Scopus" |
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