Phase I clinical trials in oncology: ethical issues

The scientific goal of phase I clinical trials in oncology is to determine and optimise the drug dose and schedule on the basis of the toxicity profile. These trials also respond to a need: they offer the chance of early access to a new therapy for cancer patients who are characterised by both the lack of a therapeutic option and a desire to fulfil personal ambitions. The therapeutic relationship in this context must reconcile unreasonable hopes and anxiety regarding death and follow the same rules as in other doctor-patient relationships, with the triple requirement being that it should be genuine, therapeutic and empathetic.