Review of the best case series methodology: best case series results of East-West Cancer Center.

PURPOSE To assess the efficacy of the best case series program methodology as a preliminary evaluation of complementary and alternative programs. SETTING East-West Cancer Center (EWCC) is a traditional oriental cancer center located in Daejeon, Korea. Cancer patients received Wheel balance therapy (WBT), which focuses on rediscovering homeostatic harmony with dietary therapy, metabolism-activating therapy, antiangiogenesis and immune system therapy, and controlled breathing and psychotherapy. METHODS Summaries of 6 cases in which patients showed longer survival without progression and were treated with WBT without conventional treatments were submitted for review to the National Cancer Institute (NCI) Office of Cancer Complementary and Alternative Medicine. Each case was then classified by the NCI review panel with pathologic confirmation of disease and radiologic confirmation of complete response or partial response not attributable to conventional treatments. RESULTS Two of 6 cases were classified as evaluable NCI best cases; the other 4 cases were classified as unevaluable. Except for a patient with squamous cell lung carcinoma, no patient showed further progression as of July 2007. CONCLUSION The best case series program provides a preliminary evaluation of complementary and alternative medicine programs. But the method will only find treatments that have effects similar to those of conventional methods such as surgery, chemotherapy, and radiation therapy. Therefore, in future studies, BCSP reviewers should additionally consider assessing tumor dormancy and efficacy of combination therapies for Best Case qualification.