[Issues in cancer treatments--EBM, individuation, and standardization]

This review emphasizes the following conclusions. Every doctor in Japan is required to recognize that individuated treatments of cancer patients are also necessary to be based on the concept of EBM (evidence based medicine). To do so, it is essential for the doctors to conduct or join clinical trials in Japan more and more. This gives us more evidences applicable to our patients, and deeper analysis for foreign clinical trials. In the 90's, the concept of EBM was introduced to the Japanese medical profession. More recently, advances in molecular biology provided possibilities to customize treatments of individual cancer patients. Some of the new approaches became drugs already approved, such as Herceptin (Trastuzumab), Iressa (ZD1839), and Gleevec (ST1571). This trend, however, may justify even experimental treatments without enough evidence, because some Japanese doctors still rarely understand the concept of EBM. This review begins with mention of the origin of EBM and the methodology of EBM. Then topics in the "individuation" are discussed. Lastly, the need for "standardized-individuated-treatments" is argued.