tag:blogger.com,1999:blog-19490962.post1614090369362567095..comments2023-12-10T10:06:41.979+00:00Comments on mutations of mortality: Super CrunchersTerry Hamblinhttp://www.blogger.com/profile/06346629921055055879noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-19490962.post-86652215017030001232010-08-02T09:17:47.749+01:002010-08-02T09:17:47.749+01:00The classic way is to choose chlorambucil as the c...The classic way is to choose chlorambucil as the comparator since it is licensed to treat CLL. Then they choose an inadequate dose - say 40 mg/sq m/ month. Fludarabine, and alemtuzumab were both licensed on this basis. With bendamustine they were more subtle, giving one drug in mg/sq m and the other in mg/kg, but instead of choosing actual weight, they chose ideal weight, which in most cases led to underdosing of chlorambucil. We know from successive MRC trials that chlorambucil dose is critical. When given at its optimal dose it has the same effect as fludarabine but is less toxic.<br /><br />The other thing they do is to refuse to ask the right questions. Is ofatumumab better than rituximab? There are no head-to-head comparisons. Fludarabine v cladribine? FCR v PCR? FCR lite v FCR? Why would they? Somebody would have to lose. Since most trials are paid for by the manufacturers there is no incentive to do these trials. In the UK the NHS is paying for a trial that looks at low dose rituximab v full doses. But even so the manufacturers have set up a 'spoiler' trial to reduce the recruitment to the NHS trial.Terry Hamblinhttps://www.blogger.com/profile/06346629921055055879noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-63102585058482829472010-08-01T22:07:50.439+01:002010-08-01T22:07:50.439+01:00...by recognizing the flaws in clinical trials, ju......by recognizing the flaws in clinical trials, just as I have in pointing out how the manufacturers cheat in their trials of supposedly new drugs against chlorambucil in CLL. You have to be aware of the tricks that are played in RCTs.<br /><br />Would you please enlighten us in detail how the manufacturers cheat in their trials. Be interesting to read as a number of CLL people are on trials or considering trying one. Thanks.Mikenoreply@blogger.comtag:blogger.com,1999:blog-19490962.post-18327118860315612742010-07-31T23:16:33.492+01:002010-07-31T23:16:33.492+01:00Never mind Terry, I figured it out
john listonNever mind Terry, I figured it out<br /><br />john listonAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19490962.post-64988907677725520272010-07-31T05:11:18.695+01:002010-07-31T05:11:18.695+01:00Terry: I'm looking for the blog you wrote on L...Terry: I'm looking for the blog you wrote on Lymphomas someone I know was just Dxed. Is there a way I can search for it?<br /><br />john listonAnonymousnoreply@blogger.com