Impact of Clinical Trial Participation on Survival of Patients with Metastatic Non-Small Cell Lung Cancer.
Clin Lung Cancer
; 22(6): 523-530, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34059474
ABSTRACT
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 ANDMETHODS:
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.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Participação do Paciente
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Análise de Sobrevida
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Ensaios Clínicos como Assunto
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Carcinoma Pulmonar de Células não Pequenas
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Neoplasias Pulmonares
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Metástase Neoplásica
Tipo de estudo:
Prognostic_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Clin Lung Cancer
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2021
Tipo de documento:
Article