A key issue is that most of the pharmacologic data discussed may not have been obtained in those patients who form the majority of the elderly population—at least among those over age 75—ie, those with comorbidities. The authors do caution us that pharmacokinetic data in older patients are limited due to the inclusion of only a small number of these patients in studies with a wide range of ages...

The prototype taxane antineoplastic agent paclitaxel, was first isolated from the bark of the Western yew tree in 1971. It and its congener, the semisynthetic derivative docetaxel, display unique pharmacodynamics as mitotic spindle poisons, differing from the vinca alkaloids and colchicine derivatives in that they bind to a distinct site on β-tubulin and promote rather than inhibit microtubule ...

Unfortunately, the vast majority (90%) of new anticancer agents designed in the laboratory never make it into routine clinical use. The hypothesis of this lecture is that many new agents fail in the clinic because the appropriate clinical trial(s) that could exploit the attributes of the new agent are not performed. An appreciation that both bench and clinical investigations are difficult endea...

McDonald et al. searched for reasons why Canada and other countries might separate their cancer drug HTA process. They appraised whether any of the rationales they found were derived from the assumption commonly made by health economists that ‘‘the goal of society or decision makers is to maximize the total aggregate health benefit conferred to a population for a given level of resources’’. The...