Design issues with lutetium-177 PSMA-617 registration studies that bias the outcome of the experimental arm reflect an increasing misalignment of contemporary oncology trials with true patient benefit.

In the PSMAfore randomized controlled trial patients with chemotherapy naïve castrate resistant metastasized prostate cancer (CRPC) progressing after one line of a second-generation androgen receptor signaling inhibitor (ARSI) were randomized to the experimental arm of lutetium-177 PSMA-617 or the control arm of another ARSI. The trial showed an increase in the primary endpoint radiographic progression free survival in the experimental arm. Previously, the VISION trial led to the approval of lutetium-177 PSMA-617 in patients with CRPC progressing after at least 1 second generation ARSI and at least 1 line of chemotherapy with a taxane.

Pharmaceutical company funding of cancer patient advocacy organizations in the Netherlands.

Background: Financial conflicts of interest (FCOI) of medical professionals and associated organizations with pharmaceutical companies (pharma) might contribute to the use of low value oncological treatments. Value criteria for oncological drug approvals in the Netherlands have recently become more stringent leading to objections by cancer patient advocacy organizations (cPAOs). Considering the importance of cPAOs input in cancer patient care we analyzed whether pharma funding of cPAOs occurs in the Netherlands.

Pharmaceutical Industry Payments to Medical Oncologists in the Netherlands: Trends and Patterns Provided by an Open-Access Transparency Data Set.

Purpose: Health care expenditure related to oncologic treatments is skyrocketing although many treatments offer marginal, if any, clinical benefit. Financial conflicts of interest (fCOI) resulting from pharmaceutical industry (pharma) payments to physicians is increasingly recognized as a predictive factor for regulatory board approval and guideline incorporation of low-value treatments. We sought to study the extent to which pharma payments to medical oncologists occur in the Netherlands, the amount of money involved, and whether these occur more frequently and are higher for key opinion leaders (KOLs).

Untoward global effects of current guideline formulation of stereotactic radiotherapy for symptomatic brain metastases by international medical societies.

The quality of evidence leading to new oncological treatments suffers shortcomings, as has recently been addressed for drug approvals. In this 'Personal view', we evaluate the unintended effects of adopting stereotactic radiosurgery as the standard of care for patients with limited number of symptomatic brain metastases and favourable prognostic factors in international guidelines in view of the limitations in the evidence of efficacy and effectiveness, with special focus on countries with relatively limited resources.