Nature, 20 September 2024

Leveraging the potential for deintensification in cancer care

Evidence-based reductions in cancer treatment that still preserve outcomes can result in an improved quality of life for patients and optimized healthcare resourcing. Using melanoma as an example, we define treatment deintensification, outlining barriers to its implementation, as well as existing guidance.

Improvements in the diagnosis and management of cancer have been translated into large gains in survival and reductions in treatment toxicity. The rate of drug discovery continues to increase — but there is growing concern about the disproportionate cost–benefit ratio associated with new therapies. Overall rising healthcare costs are competing within a finite resource pool, and affecting access to healthcare. Among higher-income countries, this is perhaps most pronounced in the USA, where growing political pressure and momentum has led to a series of Presidential Executive Orders and law reforms aimed at improving healthcare access and reducing the costs of prescription drugs. With this in mind, policymakers and healthcare managers are looking at how best to prioritize investment in order to optimize health outcomes.