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Do patients with advanced-stage non-small cell lung cancer (AS NSCLC) live longer if managed within a clinical trial setting?
Abstract   Peer reviewed

Do patients with advanced-stage non-small cell lung cancer (AS NSCLC) live longer if managed within a clinical trial setting?

Taher Abu Hejleh, Elizabeth A Chrischilles, Thorvardur Ragnar Halfdanarson, Jane F Pendergast, Dingfeng Jiang, Carmen J Smith, Aaron T Porter, Robert B Wallace and Cancer Care Outcomes Research and Surveillance Consortium (CanCORS)
Journal of clinical oncology, Vol.30(15_suppl), pp.6034-6034
05/20/2012
DOI: 10.1200/jco.2012.30.15_suppl.6034

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Abstract

6034 Background: Treatment outcomes of AS NSCLC (stages IIIB and IV) are poor. There is an argument that participation in a clinical trial (CT) may confer survival benefit, probably, through enhancing quality of care. In this study, we explore the survival outcomes and perceived care quality for AS NSCLC patients (pts) treated within vs outside a CT. Methods: Data were obtained from surveys of newly diagnosed AS NSCLC pts studied by the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), a large cohort of pts across the United States. Pts who did not complete the baseline survey were excluded as this was associated with worse performance status (PS). Baseline characteristics according to CT participation were determined. Association between CT enrollment and survival was explored utilizing univariate and multivariate survival analysis after adjusting for age, comorbidities and self-reported PS. Results: Of 815 AS NSCLC pts, 56 (7%) were enrolled on a CT. Chemotherapy trials comprised 67% of all trials. Of the 815 pts, 697 (86%) died. Median survival for pts within vs outside a CT was 62 vs 64 months. Neither age, comorbidities nor recalled PS differed significantly between pts within vs outside a CT (P=0.2085, 0.5818 and 0.1678 respectively). On the multivariate survival model, CT enrollment did not correlate with longer survival (P=0.8811) and only presence of comorbidities was associated with worse survival (P=0.0021). Comparing pts according to CT enrollment, there was no significant difference in symptom management, receiving hospice care (P=0.606), death location (P=0.2018), or following pts’ wishes (P=0.8321). However, perception of the overall cancer care quality was greater among CT enrollees (P=0.0171). Conclusions: Management of AS NSCLC pts within a CT setting conveyed a perception of superior care that did not translate into survival benefit after adjusting for differences in age, comorbidities, and self-reported PS. These findings suggest that providing cancer care within a CT should not imply a survival benefit when counseling AS NSCLC pts about entering CTs.

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