[Let's go forward, but wisely…]

In recent years, the oncologic community has been widely debating the high costs of new anti-cancer drugs, that put at risk the sustainability of the health care system. In a study published in BMJ in October 2017, Davis and colleagues analyzed clinical trials conducted with anti-cancer drugs approved by the European Medicines Agency between 2009 and 2013. The authors emphasized that most anti-cancer drugs have been approved without any evidence of an improvement in overall survival and/or in quality of life. However, the consciousness about the importance of "raising the bar" for treatment value has recently increased, not only in regulatory agencies, but also among medical oncologists and scientific societies. The frameworks designed by ASCO and ESMO to quantify treatment value have been firstly published in 2015, that is after the years analyzed by Davis and colleagues. We strongly hope that the same kind of analysis, if repeated for the subsequent 5 years, could document a trend of improved magnitude of benefit. This improvement would be particularly relevant, considering that the debate about the relevance of results obtained with anti-cancer drugs is necessarily going to grow. Let's go forward, but wisely….