Traditional trial designs are wasteful, said Dr. Mehanna. The future holds adaptive, efficient clinical trial designs that are multi-arm and multi-modal, allowing for earlier assessment and substitution of arms, and assessing at successive stages to allow discarding arms that show no progress. International collaborations, such as the newly formed Head and Neck Cancer International Group, will allow delivery of trials to larger populations.
Explore This IssueNovember 2019
“But surgeons still need to do better, Dr. Mehanna said. “We are recruiting and supporting recruitment into trials,
but only where the trials do not impinge on our decision making.” While there are exciting developments in trials and research, Dr. Mehanna implores surgeons to do more to overcome their biases and lack of equipoise.
“As I’ve hopefully demonstrated,” he said, “please don’t change your management without good level 1 evidence from trials, because the effects can be pretty significant on our patients.
Renée Bacher is a freelance medical writer based in Louisiana.