New drugs and options can enhance patient outcomes: But can they also erode them?

The expanding list of treatment options available to patients with cancer is a source of excitement. Drugs with novel mechanisms of action receive attention at academic meetings and approval of novel drugs are cited as a victory of medical research. This is evidenced by the interest in number of new drug approvals each year. The Food and Drug Administration provides a yearly report of New Molecular Entities approved by the Center for Drug Evaluation and Research. High numbers of approved drugs is celebrated and equated with improvement in patient outcomes, as well as evidence of the effectiveness of regulatory agencies [1]. While more effective therapies lead to improved outcome, merely having more options may erode outcomes in unexpected ways. We discuss 3 different clinical scenarios where having more options can lead to worse outcomes.