Evidence-based medicine has become a requisite for novel therapies. It requires demonstration, in well performed clinical trials, that a benefit for the patients can be obtained by changing what is considered as a standard treatment. The present review deals with the clinical trials in the field of cancer therapy which have been published, during 2004, mainly in the New England Journal of Medicine (NEJM). We selected this mode of operation since the NEJM publishes highly selected papers after thoroughful peer review; moreover, the selection of the paper published by the NEJM is intended for general practionners in the different areas of medicine and critical editorial comments are offered for major contributions.