Differences in survival between usual practice and clinical trial participants in advanced NSCLC by age

Autor: Victor Navarro Pérez, Natalia Luque Caro, David Fernández Garay, María Ruiz Sanjuan, Miguel Angel Moreno Jimenez, Pedro López Leiva, Ana Laura Ortega Granados, Capilla de la Torre Cabrera, Maria Carmen Álamo de la Gala, Rosario Dueñas García, Esther Martínez Ortega, Francisco José García Verdejo, Yessica Plata Fernández, Juan Francisco Marín Pozo, Nuria Cárdenas Quesada, Rosa Millán García, Mónica Fernández Navarro, Ana Jaén Morago, Maria Lomas Garrido, Pedro Sánchez Rovira
Rok vydání: 2017
Předmět:
Zdroj: Journal of Clinical Oncology. 35:e20515-e20515
ISSN: 1527-7755
0732-183X
Popis: e20515 Background: It is known that outcome of patients included in clinical trials have a better outcome than patients treated with standard therapy. This is a retrospective case-control study of outcome of patients with stage III and IV non-small cell lung cáncer (NSCLC) recruited in clinical trials vs advanced NSCLC patients in usual clinical practice in our institution. Methods: We performed a case-control study matching all patients participating in trials with chemotherapy and/or TKis (immunotherapy was not included) in a 5 year period (January 2010-November 2014) in 1st line setting, matching them in a ratio 1:2 with individuals in usual clinical practice. There were 36 patients in trials and 72 patients treated by our protocol. Cases were matched by age ( < 65 and > 65), histology (adenocarcinoma and squamous), EGFR status (mutated and wild-type). All patients were WHO performance status 0-1. Results: Patients in each group were matched for stage, histological subtype, previous surgery and systemic therapy. Median follow up for patients treated on a trial was 3.3 years, compared with 2.9 years for matched patients who received standard 1st line therapy. Median overall survival for patients included a trial was 19.6 months, and 15.7 months for control group. The difference between groups was not significant (Log rank test, HR 0.81, 95% CI: 0.42 to 1.30, p = 0.53). Median overall survival in younger patients in trials ( < 65) was 19.3 months, and in elderly patients was 19.8 months. The median progression-free survival in the two groups was 6.8 and 5.5 months respectively (HR 0.72, 95% CI 0.30 to 1.43, p = 0.21). Conclusions: In our institution, we didn’t found significant differences for overall survival or progression-free survival, but there is a trend for a better outcome for those items. Benefit seems to be similar in younger patients than in older patients, so this encourages recruiting of selected elderly patients.
Databáze: OpenAIRE
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