Controversy Over Paper on Chemosensitivity Testing

Controversy Over Paper on Chemosensitivity Testing

In December 2000, ONCOLOGY’s Jim McCarthy sent me a letter, inviting me to prepare an article for the journal on "The Current Status of Chemotherapy Sensitivity Assays." I was informed that the paper would be referred to one or two reviewers, who would write a commentary to be published alongside the paper. The commentary, I was told, might be "entirely laudatory, highly critical, or somewhere in between," and the result, "both lively and informative."

I prepared and submitted the article, but more than 4 months later, I received a terse notice that it would not be published. This led to an exchange of correspondence and a reaffirmation of ONCOLOGY’s decision not to publish the paper.

In an era of ever-increasing numbers of partially effective cancer therapeutics, there is an obvious need for technologies to better match treatment to patient. The field of chemotherapy sensitivity assays has been controversial, but there is a substantial literature that has not been recently reviewed and with which the vast majority of clinical oncologists are not familiar.

Approximately 10,000 individual patient specimens are currently being submitted for testing by more than 1,000 clinical oncologists, surgeons, and pathologists annually in the United States. Not infrequently, the tests engender uninformed reactions and opinions from various clinicians within the referring medical centers.

In short, this is a timely and important topic for review, consideration, and debate. However, my manuscript was rejected with an initial explanation stating only that "the subject is just too controversial."

D.F. Horrobin published a commentary[1] on the peer review process, which is relevant to situations such as this. He states:

Peer review can be performed successfully only if those involved have a clear idea as to its fundamental purpose. Most authors of articles on the subject assume that the purpose of peer review is quality control. This is an inadequate answer.... Peer review must therefore aim to facilitate the introduction into medicine of improved ways of curing, relieving, and comforting patients. The fulfillment of this aim requires both quality control and the encouragement of innovation. If an appropriate balance between the two is lost, then peer review will fail to fulfill its purpose.

I believe that I succeeded in preparing a complete and up-to-date review of an important and poorly understood topic. The complete text of this review as originally submitted, along with the verbatim comments of the single reviewer, and all correspondence between ONCOLOGY and me are available to interested readers on the following website:

Medical Oncology & Laboratory Medicine
Huntington Beach, California


Dr. Weisenthal’s paper was submitted to our editorial reviewers, and the consensus recommendation was to decline publication. Dr. Weisenthal was provided, anonymously, with the full text of one of the peer reviewer’s lengthy comments as well as the essence of other reviewers’ recommendations, the consensus of which is that, in their opinion, the science just doesn’t support the clinical recommendations in his paper.

Senior Vice President, Editorial


1. Horrobin DF: The philosophical basis of peer review and the suppression of innovation. JAMA 263:1438-1441, 1990.

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