From snapshots to a movie. Challenging the patterns of academic research.

Perrone, Francesco

Academic research should foster study projects focused on the efficacy of therapeutic pathways (patient-journey studies) instead of just individual drugs. The research for registration purposes gives us snapshots, thanks to which the new drugs arrive on the market. What is before the photo is not necessarily clear; for example, the characteristics of the patient population, which often differ between the trial and clinical practice that could begin years later. As it is not clear what there is after the photo; for example, the subsequent treatments which also change over time. Indeed, the time frame following the photo is often deliberately obscured by using surrogate endpoints that overestimate advantages. Regulatory agencies are called upon to decide on registration and reimbursement despite being essentially unable to fully understand the value, positioning and economic consequences of new drugs. This is the field in which independent research must try its hand in the coming years. By designing studies on therapeutic pathways, which assess the effectiveness of therapeutic sequences by looking at the entire patient-journey and not at the efficacy of individual drugs. Something like going from a series of snapshots to a movie.