The burden of scientific progress: growing inequalities in the delivery of cancer care.

Novel targeted therapies are now a reality in oncology. The monoclonal antibodies trastuzumab, rituximab, cetuximab and bevacizumab have a proven benefit in both advanced and early stage cancers. Furthermore impressive new technologies such as gene profiling, circulating tumour cells and proteomics are becoming major tools for prognostic assessment and prediction of response to certain treatments. Whilst this is certainly good news for patients it comes at a price, many of these technologies are very expensive and may result in unprecedented inequalities in the delivery of cancer care. The largest impact may be on developing countries, but inequalities are starting to be felt in some developed nations. Strategies to tackle the resource implications need to be addressed alongside the development of these technologies.