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A new cancer care dilemma: Patients want immunotherapy even when evidence is lacking

Doctors' new dilemma: Can they justify prescribing an immune therapy when it hasn’t been tested for a patient’s particular type of cancer?

Immunotherapy is a source of great hope in cancer care. It has rescued some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds.

But these therapies are also creating a vexing dilemma for doctors: Their patients, citing television ads and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.

Doctors want to give their patients every shot at survival, but can they justify prescribing a drug when it hasn’t been tested for that patient’s type of cancer? Many of these treatments bring risks of painful — even life-threatening— side effects and carry total price tags pushing $1 million. In some cases, insurers won’t pay.

“Whether it works or not, the burden both financially and emotionally on families and

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