title: Use of palliative radiotherapy trials for clinical biomarker development.
abstract: BACKGROUND
  Approximately one quarter of all cancer patients will require palliative radiation treatment at some point during the course of their disease, but only a minority of these patients are entered in clinical trials.
  We review the literature debating the ethics of inclusion of "palliative" patients on clinical trials. We suggest that these patients provide a potentially valuable resource that can be leveraged to facilitate the discovery and validation of biomarkers predictive of radiation response and toxicity. In addition, this patient population offers valuable opportunities to test combination of radiation and targeted therapies to screen for activity, toxicity and biomarkers in a relatively safe manner.
  
  
  CONCLUSIONS
  Patients undergoing palliative radiation therapy may provide new opportunities for the development and testing of predictive radiotherapy biomarkers as well as affording opportunities to test combinations of radiation and targeted therapies.
authors.affiliation: Radiation Medicine Program, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wan
authors.forename: Michael
authors.initials: M
authors.lastname: Milosevic
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Brade
mesh_terms: D014408:Biomarkers, Tumor; D002986:Clinical Trials as Topic; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010166:Palliative Care
chemical_list: D014408:Biomarkers, Tumor