Landscape and evolution of therapeutic research for breast cancer patients.

Breast cancer survival rates have improved, new disease classifications have been adopted, and increased awareness about symptom management has arisen. Nevertheless, it is unknown to what extent these changes have had any impact on the way clinical trials are conducted. To address this question, the evolution of clinical trials in the breast cancer field between 2007 and 2011 was evaluated. The data source was www.clinicaltrials.gov . Results corresponding to the search terms "breast cancer" were downloaded and studies starting between 2007 and 2011 using the "start date" field were analyzed. 2059 clinical trials were started in the breast cancer field between 2007 and 2011. Although the overall number of studies was stable, the number of studies evaluating a drug efficacy decreased steadily between 2007 (n = 206) and 2011 (n = 170). The number of patients enrolled in those trials also dramatically decreased. In contrast, the number of patients involved in symptom management studies increased during this time period. In the same time, conventional and targeted therapies decreased by 26 % and 20 %, respectively. Finally, the number of small phase II trials performed in unselected populations decreased drastically between 2007 (n = 47) and 2011 (n = 26), replaced by large international phase II trials, phase I studies, and biomarker-driven trials. Symptom management became the most investigated topic in breast cancer. The research on drug development is drastically decreased in breast cancer, mainly due to the decrease in phase II trials.