Impact of Clinical Trial Participation on Survival of Patients with Metastatic Non-Small Cell Lung Cancer
| Autor: | Cristina Merkhofer, Renato G. Martins, Scott D. Ramsey, Keith D. Eaton, Bernardo H. L. Goulart |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Washington 0301 basic medicine Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty Lung Neoplasms media_common.quotation_subject Article 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Internal medicine medicine Humans Registries Neoplasm Metastasis Lung cancer Survival analysis Aged media_common Selection bias Clinical Trials as Topic Performance status business.industry Cancer Middle Aged medicine.disease Survival Analysis Cancer registry Clinical trial 030104 developmental biology Oncology 030220 oncology & carcinogenesis Mutation Propensity score matching Female Patient Participation business |
| Zdroj: | Clin Lung Cancer |
| ISSN: | 1525-7304 |
| Popis: | Introduction The impact of clinical trial participation on overall survival is unclear. We hypothesized that enrollment in a therapeutic drug clinical trial is associated with longer overall survival in patients with metastatic non-small cell lung cancer (NSCLC). Patients and Methods We linked electronic medical record and Washington State cancer registry data to identify patients with metastatic NSCLC diagnosed between January 1, 2007, and December 31, 2015 who received treatment at a National Cancer Institute–designated cancer center. The exposure was trial enrollment. The primary outcome was overall survival, defined as the date of second-line treatment initiation to date of death or last follow-up. We used a conditional landmark analysis starting at the date of second-line treatment initiation and propensity scores with inverse probability of treatment weighting to estimate the association between trial enrollment and survival. Results Of 215 patients, 40 (19%) participated in a second-line trial. Trial participants were more likely to be never smokers (45% vs 27%), have a good performance status (88% vs 77%) and have EGFR (48% vs 14%) and ALK mutations (8% vs 5%) than nonparticipants. Trial participants had similar overall survival to nonparticipants (HR 1.05; 95% CI, 0.72, 1.53; p = 0.81) after adjusting for sociodemographic and disease characteristics. Conclusion Accounting for the immortal time bias and selection bias, trial participation does not appear detrimental to survival. This finding may be reassuring to patients and supports programs and policies to improve clinical trial access. |
| Databáze: | OpenAIRE |
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