Oncology with common sense: beyond biologistic and pharmacological models

Rapid advances in oncology have led to unprecedented pharmacological and technological complexity, yet these developments have not always translated into meaningful benefits for patients. Inspired by the Common Sense Oncology movement, this article reflects on the need to recalibrate cancer care beyond biologistic and industry-driven models. We argue for a broader, patient-centred vision of oncology that integrates social determinants of health, prevention, supportive and palliative care, shared decision-making and independent research alongside pharmacological innovation. Drawing on evidence from health economics, clinical research trends and public health, we highlight the paradox between rising oncology expenditures and limited gains in overall survival, quality of life and equity. We also discuss the growing influence of industry-sponsored research, the increasing reliance on surrogate endpoints, and the underfunding of non-pharmacological and psychosocial interventions. Finally, we propose concrete priorities for policymakers, clinicians and research institutions to ensure that oncology progress remains aligned with outcomes that truly matter to patients.