If standard treatments for cancers fail, doctors sometimes【C1】_____drugs that haven’t been approved for that particular cancer type. In the Netherlands, this is now being done as part of a new kind of【C2】__, so we can get a better idea of which drugs work for what cancers—and which don’t. The results from the first 215 people show that a third of them saw some benefits from the “off-label” use of drugs. One or two completely【C3】_____. says Emile Voest at the Netherlands Cancer Institute in Amsterdam.

A new drug【C4】_____an approval process for【C5】__a specific disease, such as a certain kind of breast cancer. Once a drug is【C6】__for one purpose, doctors can prescribe it for another. This is typically done【C7】__an ad-hoc basis. One doctor will decide which drug, if any, might help a patient who has【C8】__other options. But there is no systematic way of reporting the outcomes to help other doctors in【C9】_____situations.

The approach can help some people, but it can also go horribly【C10】_____. In the 1980s, some heart drugs were widely used off-label in the United States. Later trials suggest that this【C11】_____50,000 premature deaths.

So Voest and his colleagues have set up a more【C12】_____way of using off-label drugs for cancers. The starting point is to【C13】__the whole genomes of tumours in people for whom standard treatments have failed, and to use that information to【C14】_____drugs that might help them.

In the trial, a person with a【C15】_____tumour type is assigned a drug that might help. Similar patients don’t take the same drug【C16】__eight people have tried it. If no one benefits, no more people with that tumour type will be given that drug. If at least one benefits, more patients are【C17】_____to see if others benefit too.

In the Netherlands, the trial has been 18 with the help of hospitals, charities and pharmaceutical companies, which are donating the drugs free of charge. The number of patients now【C19】________1,000.

Several other countries including Canada, Denmark and Italy are【C20】________the protocol recently. The findings of the trial should still be checked by proper randomised controlled trials, says Voest.

【C8】