Related Experiment Video

Updated: Oct 1, 2026

Novel Apparatus and Method for Drug Reinforcement
07:32

Novel Apparatus and Method for Drug Reinforcement

Published on: August 20, 2010

Does a drug do better when it is new?

R Fossati1, C Confalonieri, G Apolone

  • 1Department of Oncology, M. Negri Institute, Milan, Italy. fossati@marionegri.it

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|May 9, 2002
PubMed
Abstract

Insights

Clinicians may overestimate drug efficacy due to wish bias. A study of doxorubicin chemotherapy for advanced breast cancer found response rates significantly decreased over time, suggesting a need for objective trial methodologies.

Area of Science:

  • Oncology
  • Clinical Pharmacology
  • Biostatistics

Background:

  • Clinician perception of drug efficacy can be influenced by biases, such as wish bias, leading to overestimation of treatment effectiveness.
  • Assessing new therapeutic approaches requires careful consideration of potential psychological influences on perceived outcomes.

Purpose of the Study:

  • To investigate the trend in response rates for doxorubicin-based chemotherapy in advanced breast cancer over time.
  • To assess the impact of wish bias on the evaluation of chemotherapy effectiveness in clinical trials.

Main Methods:

  • Retrospective analysis of 29 randomized clinical trials (1975-1999) involving 2234 women with advanced breast cancer.
  • Multivariate logistic regression was used to assess global response rates in doxorubicin-containing arms, accounting for chemotherapy regimen and prior adjuvant therapies.

Main Results:

  • A significant decrease in the global response rate to doxorubicin as first-line treatment was observed over time (odds ratio = 0.89, 95% CI 0.81-0.99).
  • This decline persisted even after adjusting for variations in therapeutic management.

Conclusions:

  • Findings suggest a potential decline in doxorubicin efficacy for advanced breast cancer over time, independent of treatment modifications.
  • The study supports the use of double-blind methodologies for subjective endpoints to mitigate wish bias.
  • Further research is recommended to explore the clinical relevance of wish bias in medical assessments.

More Related Videos

Tracking Drug-induced Changes in Receptor Post-internalization Trafficking by Colocalizational Analysis07:48

Tracking Drug-induced Changes in Receptor Post-internalization Trafficking by Colocalizational Analysis

Published on: July 3, 2015

Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System05:10

Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System

Published on: December 11, 2016

Related Concept Videos

Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
Drug Nomenclature01:17

Drug Nomenclature

During the development of a new pharmaceutical, the manufacturer initially assigns a code name to the drug. Once approved, the drug receives a United States Adopted Name (USAN)—a generic, nonproprietary designation. Upon being listed in the United States Pharmacopeia, this nonproprietary name becomes the drug's official name. Additionally, the manufacturer assigns a proprietary name or trademark, which serves as the brand name under which the drug is marketed. It is worth noting that the same...
Drug Discovery: Overview01:26

Drug Discovery: Overview

Drug discovery is a multifaceted process involving extensive screening, testing, and optimization of lead compounds to identify potential new drugs for therapeutic use. It combines several approaches, including screening large numbers of natural products, chemical modification of known active molecules, identification of new drug targets, and rational design based on biological mechanisms and drug-receptor structure. These approaches are carried out in both academic research laboratories and...
Drug-Receptor Interactions01:29

Drug-Receptor Interactions

Drug-receptor interaction describes the binding of receptors by drugs, but not all drug-receptor interactions result in activation and tissue response. For instance, the binding of agonists activates the receptor to generate a cellular reaction, while antagonists bind to receptors without causing their activation.
Several parameters, such as the drug's affinity for its receptor and its efficacy, which is its ability to activate the receptor, determine the drug's effect on the tissue.
Prodrugs01:30

Prodrugs

Prodrugs are a class of pharmaceutical compounds that undergo a biotransformation process within the body to be converted into a pharmacologically active drug. Prodrugs are designed to improve the therapeutic properties of the parent drug, such as enhancing bioavailability, increasing stability, or reducing toxicity. The concept of prodrugs revolves around modifying the chemical structure of the original drug to make it more effective or convenient for administration.
Prodrugs help overcome...
Principles of Drug Action01:24

Principles of Drug Action

Drugs are chemical substances that modify biological responses by interacting with macromolecular targets such as receptors, ion channels, transporters, and enzymes. Pharmacodynamics describes the course of action of drugs leading to the physiological effect at a specific site in the body.
Drugs can be agonists or antagonists. Like the endogenous ligands, agonists always bind and activate the target to produce a cellular response. Agonist binding induces a conformational change which in turn...