Maurie Markman, MD

Articles

Public Health Sector Groans Under Burden of Multiple Epidemics

March 27th 2020

This has been a difficult time for public health policy and regulatory organizations struggling to deal with rapidly changing and unquestionably serious societal health-related issues and concerns. The list of problems these agencies must tackle is growing, and so are the questions about the strategies that should be used to address these threats.

Vaccines Show Promise and Pitfalls of Public Health Strategies

March 13th 2020

Segments of the population have apparently rejected the well-documented clinical utility of vaccination for protecting individual and public health. An immediate specific concern is the contentious matter of measles vaccination, which has been well-reported in the lay press.

Can Pragmatic Trials Bend the Antineoplastic Therapy Cost Curve?

February 26th 2020

Clinical trials in oncology serve several purposes; these efforts ultimately help define and, potentially, modify the "standard of care" in routine cancer management.

If Only That Phase III Oncology Trial Had Been Designed Differently

February 19th 2020

The cancer treatment community's ultimate perception of a successfully completed phase III randomized trial depends in large part on how well the trial was conceived and structured. To permit adequate accrual in a timely manner and optimize the chances for a study to achieve success, the question it poses must be relevant to ensure interest by clinical investigators, referring clinicians, and potential research subjects. Further, the initiative must have adequate funding for data collection and analysis, translational laboratory investigations, and other trial components.

Germline Testing Holds Promise But Demands a Cautious Approach

January 23rd 2020

A better understanding of how unique germline variants affect the metabolism or elimination of individual agents or drug classes could lead to a truly revolutionary change in the way cancer is treated.

Patient Input Should Inform Oncology Trial Design and Interpretation

January 13th 2020

Even the most basic investigation into fundamental mechanisms of the development and progression of cancer in an in vitro system may generate data that, ultimately, prove vital to developing new approaches to prevent, diagnose, and treat malignant disease.

Success Breeds a Need for Oncology Trials That Tackle Real-World Questions

December 30th 2019

Placing the results of a single trial in the context of real-world, everyday practice is increasingly difficult because of the number of available options and the absence of studies that directly compare individual strategies.

The Dividing Line for Germline Mutation Testing Is Often Arbitrary

December 18th 2019

Although hereditary cancer risk was defined solely by family history in the not-so-distant past, today increasingly robust data may help define an individual’s heightened lifetime risk based on the presence of specific molecular findings within the germline

A Society That Worries About Risks Should Consider Cancer Prevention

November 23rd 2019

When discussing the topic of vaccination to prevent serious childhood illness, an increasing number of individuals refuse to accept the unequivocally demonstrated value of this public health strategy despite the very low risk of harm.

Cancer Research Versus Care: Just How Different Are the Goals?

November 13th 2019

The often intense and frequently highly focused effort to seek scientific purity in answering questions within cancer clinical trials raises serious concerns regarding the ethical foundation of certain studies.

Tips for Talking With Patients: "Mother Question" and Sleep Test

October 30th 2019

Certain themes and questions about individualized, scientifically unanswerable dilemmas often recur when talking with patients and families about treatment.

End-of-Life Treatment Has Important Nuances

October 13th 2019

Even if a disease is diagnosed as “incurable,” or progression to a state of incurability subsequently develops, the time between diagnosis and death is being prolonged and the quality of life improved with novel oncologic interventions, such that continued therapeutic efforts are justified.

Informed Consent Means Patients Should Be Informed

October 1st 2019

There is no more important principle in the conduct of legitimate therapeutic investigation than ensuring the adequacy of informed consent of the prospective clinical trial participant.

Small Subgroups May Hold Big Clinical Clues in Oncology

September 23rd 2019

With the revolution in our understanding of cancer’s basic molecular biology, it is increasingly evident that subgroups of cancer originating from specific regions of the body have unique natural histories and respond to very different therapeutics. For example, the importance of BRCA mutations, which define a subset of ovarian cancers impressively sensitive to PARP inhibitors, has striking altered the management of this group of gynecologic malignancies.

Rising Healthcare Costs Leave People Behind

August 23rd 2019

The cost of antineoplastic therapy and essential supportive care medications have a substantial negative impact on patients with cancer and their families.

Placebo Control Arms Are Deeply Flawed Scientific Tools

August 11th 2019

Particularly in the oncology arena, there are several serious scientific, ethical, and pragmatic concerns associated with ongoing reliance on placebo-controlled studies.

Control Arms Must Be Selected for Meaningful Comparison

July 24th 2019

Although concerns have been raised in recent years regarding the need for randomized trials to augment the body of clinical understanding, one critical issue that has failed to generate sufficient discussion is how the choice of the control arm affects the interpretation of an individual study’s outcome and potentially undermines the ethical basis for that particular study.

Open-Access Publishing Model May Introduce New Biases in Oncology

July 15th 2019

For clinical science, particularly oncology, there has never been a more exciting era than today.

Evolutionary Medicine May Provide Clues for Cancer Genetics

June 28th 2019

Today, with the routine performance of single gene or germline panel testing, as well as a critical focus on prospective follow-up of individuals with incompletely understood germline variants, clinicians are developing an increasingly robust appreciation for the influence of an individual’s genetic background on the likelihood of developing specific malignancies or a group of malignant conditions.

Vaccine Opponents Haven't Looked at the Evidence

June 11th 2019

It may be difficult for many who have not lived through an outbreak to appreciate how critical it is to never permit the disease to reappear.