The Role of Investigational Therapy in Management of Patients With Advanced Metastatic Malignancy

There is reason for patients and physicians to question the role of palliative chemotherapy in patients with advanced malignancy. In this unfortunate clinical situation, patients and physicians often turn to palliative care and hospice care in lieu of chemotherapy, which is clearly palliative and offers the prospect of limited effectiveness with unpleasant adverse effects. The important question to be asked is when is it too soon to abandon the prospects for a favorable outcome from investigational therapy. Many authors have concluded that investigational therapy offers such small promise of benefit that it is not worth considering. It is the purpose of this communication to emphasize the potential for investigational therapy; to illustrate it with a description of two real patient experiences; and to encourage physicians not to abandon therapeutic approaches for their patients too soon.