Nowadays, All Therapies Are Targeted-Understanding Biology Improves Disease Management

Abstract

Several decades ago, chemotherapy was the first observed efficient therapy for cancers, particularly for hematological malignancies. It was the time of case reports and short series, when the balance between efficacy and toxicity was evaluated on a patient per patient basis. This was considered as an empiric therapy, just basic clinical research supported by an intuitive and creative medical approach, inherited from medical history. Then, with the emergence of more and more drugs, methodologies and rules for clinical research were implemented with two goals: protect patients and rationalize empiric thinking. It was the time of large cohorts of patients, the time of the p value. Some progress was made as less empiricism and more science facilitated medical decision. With the development of clinical protocols, classifications, prognostic indexes and other relevant tools, including patients in clinical trials became most often the only objective for physicians and other health professionals, with the aim of raising the right questions and creating new protocols.