Often, the FDA limits access to clinical trials to patients who have failed all other approved therapies. This means that we only evaluate potential new drugs on individuals who are already very sick and have been weakened by their disease as well as their prior treatments.
Cancer cells “learn” how to survive treatments by mutating. When we use only advanced-stage patients in our clinical trials, we are actually treating men who have already been greatly been weakened and whose prostate cancer cells have already been to school. Smart, educated cancer cells can often resist therapies.
This system does not allow us to evaluate the effect of the treatments on much stronger, earlier stage prostate cancer survivors. Some of these potential treatments may be ineffective in late stage cancer, but might induce durable remissions in earlier stages.
Joel T Nowak MA, MSW