FIRST-LINE THERAPY - WHAT IS LOST WHEN NO T GIVEN

It is highly desirable to give always the best therapeutic alternative . However, the accomplishment of this goal is not always possible, lea ving the physician with second, third or no therapeutic choice at all. The reasons for this may be economic, logistic, medical and cultural. In order to know what the patients are losing, we need to test how st rong the scientific evidence is for the first choice option, and secon d, we have to consider the magnitude of improvement on clinical outcom es, comparing the best therapy and the next best available therapy. In many instances, the difference in clinical benefit is small and even negligible.