This Article Full Text Full Text (PDF) CME: Take the course for this article: Reality Testing in Cancer Treatment: The Phase I Trial of Endostatin eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Related articles in The Oncologist Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ryan, D. P. Articles by Lynch, T. J. Search for Related Content PubMed PubMed Citation Articles by Ryan, D. P. Articles by Lynch, T. J., Jr.

Reality Testing in Cancer Treatment: The Phase I Trial of Endostatin

The Kenneth B. Schwartz Center at Massachusetts General Hospital, Hematology-Oncology Department, Boston, Massachusetts, USA

Correspondence: Richard T. Penson, M.D., MGH Cancer Center and Hematology-Oncology Department, Cox Building, 100 Blossom Street, Boston, Massachusetts 02114-2617, USA. Telephone: 617-726-5857; Fax: 617-726-6974; e-mail: rpenson{at}partners.org

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.

The September 1999 Schwartz Center Rounds addressed the growing attention around the phase I trial of Endostatin^TM. Endostatin represents a new treatment paradigm. It is an anti-angiogenic protein, an endogenous fragment of collagen XVIII. In an attempt to ensure a fair allocation of a very limited number of treatment slots in this classical phase I trial, a lottery was established. More than 1,400 patients enrolled within two days of the lottery, all vying for three places in the first cohort. Two contrasting cases are presented, each a potentially eligible patient. The discussion focuses on the dilemma presented by patients desperate for an unproven treatment and the responsibility of staff to explain and support without compounding the hype or suffocating the hope.

Key Words. Endostatin • Phase I • Hype • Hope • Caregivers • Psychosocial

Related articles in The Oncologist:

Reality Testing in Cancer Treatment: The Phase I Trial of Endostatin

David P. Ryan, Richard T. Penson, Sabrina Ahmed, Bruce A. Chabner, and Thomas J. Lynch, Jr.
The Oncologist 2002 7: 58-65. [Abstract] [Full Text]  

This article has been cited by other articles:

				K Brixius, S Schoenberger, D Ladage, H Knigge, G Falkowski, M Hellmich, C Graf, J Latsch, G l Montie, G l Prede, et al. Long-term endurance exercise decreases antiangiogenic endostatin signalling in overweight men aged 50-60 years Br. J. Sports Med., February 1, 2008; 42(2): 126 - 129. [Abstract] [Full Text] [PDF]

				S. L. Berg Ethical Challenges in Cancer Research in Children Oncologist, November 1, 2007; 12(11): 1336 - 1343. [Abstract] [Full Text] [PDF]

				P. Nyberg, L. Xie, and R. Kalluri Endogenous Inhibitors of Angiogenesis Cancer Res., May 15, 2005; 65(10): 3967 - 3979. [Abstract] [Full Text] [PDF]

				A. Reijerkerk, L. O. Mosnier, O. Kranenburg, B. N. Bouma, P. Carmeliet, T. Drixler, J. C.M. Meijers, E. E. Voest, and M. F.B.G. Gebbink Amyloid Endostatin Induces Endothelial Cell Detachment by Stimulation of the Plasminogen Activation System Mol. Cancer Res., June 1, 2003; 1(8): 561 - 568. [Abstract] [Full Text] [PDF]

				L. Jiang, V. Jha, M. Dhanabal, V. P. Sukhatme, and S. L. Alper Intracellular Ca2+ signaling in endothelial cells by the angiogenesis inhibitors endostatin and angiostatin Am J Physiol Cell Physiol, May 1, 2001; 280(5): C1140 - C1150. [Abstract] [Full Text] [PDF]