Are guidelines on use of colony-stimulating factors in solid cancers flawed?
In cancer care in Australia, we are very reliant on an array of expensive pharmaceuticals. Our use of these treatments is often based on multinational or foreign clinical studies. Oncologists are, to varying degrees, reliant on how the studies are interpreted by the writers of journal editorials, clinical guidelines and opinion pieces. Therefore it is important that these guidelines are balanced and evidence based. We have examined in detail one of the most influential and wide ranging clinical guidelines used in oncology, The American Society of Clinical Oncology (ASCO) 2006 Update of Recommendations for the use of White Blood Cell Factors: An Evidence-Based Clinical Practice Guideline. We have discussed in detail some of the controversial recommendations in this guideline and have exposed what we believe are some flaws in these recommendations. We would urge that we continue to be rigorous in our oversight of international research agendas and international clinical guidelines in the future.
Haines
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Melbourne Oncology Group, Melbourne, Victoria, Australia.
Olver
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D000970:Antineoplastic Agents / Q000009:adverse effects; D016527:Drug Costs; D004345:Drug Industry; D019317:Evidence-Based Medicine; D016298:Hematopoietic Cell Growth Factors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D015201:Meta-Analysis as Topic; D009042:Motivation; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D019564:Unnecessary Procedures
D000970:Antineoplastic Agents; D016298:Hematopoietic Cell Growth Factors