Controversy Over Paper on Chemosensitivity Testing

July 1, 2002

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."

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

I prepared and submitted the article, but more than 4 monthslater, I received a terse notice that it would not be published.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

In an era of ever-increasing numbers of partially effectivecancer therapeutics, there is an obvious need for technologies to better matchtreatment to patient. The field of chemotherapy sensitivity assays has beencontroversial, but there is a substantial literature that has not been recentlyreviewed and with which the vast majority of clinical oncologists are notfamiliar.

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

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

D.F. Horrobin published a commentary[1] on the peer reviewprocess, 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 andup-to-date review of an important and poorly understood topic. The complete textof this review as originally submitted, along with the verbatim comments of thesingle reviewer, and all correspondence between ONCOLOGY and me areavailable to interested readers on the following website: www.weisenthal.org

LARRY M. WEISENTHAL, MD,PHD
Medical Oncology & Laboratory Medicine
Huntington Beach, California

ONCOLOGY Responds

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

JAMES F. MCCARTHY
Senior Vice President, Editorial
ONCOLOGY

References:

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