Talk:List of antineoplastic agents

Arbitrary selection of content and benefit-to-effort ratio in general

I have put several months of thought into how to develop this table / article. I respect the time and scholarship that went into the present tabulation. This was a huge effort; it is really quite impressive for what was essentially a one person effort using clunky wiki table syntax. However, the content issue I am addressing here is that the present method of presentation is not at all practical.

For example, the tables include a "major toxicities" field in the table. This is loosely referenced to several textbooks. The first problem is that new medicines are not going to be in these books unless there are new editions. The second problem is that the data presented is highly arbitrary. For example, for azacitidine, the U.S. package insert has 6 pages of side effect information. It is academically impossible to distill 6 pages of data, that includes comparators with grade 1/2 and gr 3/4 etc into an approximately 6 item list. Trying to do this results in anomalies. For example, we do not mention pneumonia, seen in 10.9% of recipients vs 5.4% of controls, but we mention hypokalemia, which the toxicity table shows had no increase in grade 3/4 incidence (there was a small increase in Gr 1/2). And yet hypokalemia is an "interesting" and remediable side effect that is only detected if monitored, while pneumonia may arguably "be symptomatically obvious" (often). So it depends on perspective.

This is a good practical example analogous to incompleteness theorem: it is mathematically impossible to distill / compress this amount of data into a concise list without imposing an arbitrary and incomplete methodology to filter what gets cherry-picked.

This problem in a general sense affects every one of the fields of data here. Wikipedia is just not a good environment to resolve this. On nuanced issues, such as trying to carefully select a subset of data, editors are highly polarized and the process is time inefficient. Absent a predefined agreed structure, and absent a committed editor pool that is attuned to nuanced decision making and detailed collaborative scholarship, updating and tweaking this low traffic article (average daily visitors: 37 ; recent active editors: 1) is a Sisyphean task, an exercise in futility and utter absurdity.

In the long view, after a lot of thought, my opinion is that wikipedia is really not an optimal location for this type of content, unlike regulatory agencies and professional updating services. The PDR this year sent out thumb drives with all of the content - this and professional web pages are quite honestly going to have vastly superior product than the unacceptably arbitrary content here. HemOnc.org [1] is a wiki which already deploys a considerably better structural arrangement than what exists in this article. It has a much better breadth of content than is going to be realistically feasible here. Each agent there is linked to several databases including its package insert and patient information sources. Wikipedia made the decision some time ago to de-emphasize inline external links, and for this type of content the HemOnc.org approach is the only realistic way we would ever come close to keeping up, even if we had a pool of editors. The time sink is just not productive, and whatever was chosen by one editor would be rightfully subject to endless tweaking by other editors given different perspectives and concerns. I realize that some editors still have the ambition that wikipedia capture "all meaningful human knowledge". Frankly, it isn't going to do that. This area is a good example of where "superficial" summarized data, selected as ably as possible, even if visually "nice", just isn't a proper tool to deliver information to the small number of people who visit the page. (Not to mention that we have no feedback on what visitors hope to find because that project died for all sorts of reasons.)

In the interest of trying to see if data can be retained I will review each medication as I remove content from this table, to see if any data should be moved to the individual medication articles.

I have put a lot of thought into an appropriate benefit-to-effort ratio for this article, and I think a simple alphabetic list has some merit to help users find agents that way. The therapeutic subgroup information here is already given in ATC code L01, and double sorting here in that way isn't going to add anything, so I will work on trimming that too.

FeatherPluma (talk) 16:42, 29 April 2016 (UTC)

Announcement of Changes

My name is Florian Schaub from Merck KGaA. My aim is to make some changes in this article because we have found some misleading information. I've compiled the suggested changes which you can find herinafter. They all follow one pattern:

• Current text

• Suggested revision

• Reason

• Suggested reference

If someone has objections please let me know.

_Current text

Cladribine, adenosine analog DNA methyltransferaseinhibitor, metabolites incorporate themselves into DNA.

_Suggested revision

Cladribine, adenosine analog DNA methyltransferase inhibitor, metabolites incorporate themselves into DNA.[34][35][36][37]

_Reason

Remove all reference to use of cladribine in multiple sclerosis here in this list of antineoplastic agents because Cladribine Tablets used for multiple sclerosis are not the same formulation as cladribine injection used for cancer. Also remove PO from ‘Route’ column, and ‘Waldenstrom macroglobulinaemia and multiple sclerosis’ from ‘Indications’ column as it does not currently have a label for either of these indications. Please note that the suggested amend will require removal of references 26 and 28-35. Current reference 34 becomes references 34-37 (as shown). The remaining references cited in the article will also need to be updated.

_Suggested reference

[34] Spurgeon S, Yu M, Phillips JD, Epner EM (Aug 2009). "Cladribine: not just another purine analogue?" Expert Opinion on Investigational Drugs. 18 (8): 1169–81. doi:10.1517/13543780903071038. PMID 19604118.

[35] Bryson HM, Sorkin EM (Nov 1993). "Cladribine. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in haematological malignancies". Drugs. 46 (5): 872–94. doi:10.2165/00003495-199346050-00007. PMID 7507037.

[36] Robak T, Korycka A, Robak E (Jan 2006). "Older and new formulations of cladribine. Pharmacology and clinical efficacy in hematological malignancies". Recent Patents on Anti-Cancer Drug Discovery. 1 (1): 23–38. doi:10.2174/157489206775246467. PMID 18221024.

[37] Hentosh P, Peffley DM (Jan 2010). "The cladribine conundrum: deciphering the drug’s mechanism of action". Expert Opinion on Drug Metabolism & Toxicology. 6 (1): 75–81. doi:10.1517/17425250903393745. PMID 19968576.

--Florian Schaub at Merck KGaA (talk) 13:01, 16 October 2017 (UTC)

Start to edit the article

As nobody had any objections to my announcement of changes from the 16th October I will now start editing the article.--Florian Schaub at Merck KGaA (talk) 10:42, 30 October 2017 (UTC)