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John Edwards: Lots of debate about the MARS2 RCT of mesothelioma surgery since Eric Lim’s presentation at IASLC
May 14, 2024, 13:53

John Edwards: Lots of debate about the MARS2 RCT of mesothelioma surgery since Eric Lim’s presentation at IASLC

John Edwards, Consultant Thoracic Surgeon at  shared a post on X/Twitter:

Lots of debate about the MARS2 RCT of mesothelioma surgery since Eric Lim’s presentation at IASLC (The International Association for the Study of Lung Cancer). Those who find it uncomfortable reading may attempt to raise the same issues again. The challenge – conduct a better RCT, or accept the results and move on.

My personal feelings? MARS2 was the best trial design we had with knowledge at the time, it was a pragmatic design conducted well. There will be ‘bingo cards’ stating ‘wrong patients, wrong operation, wrong surgeons’, but I believe we did our very best.

There is no signal of benefit to surgery to exploit in my view, but if others believe that they can conduct another RCT, then good luck! I screened 316 local network patients, of whom 5.7% reached randomisation, and 521 in all. They were already ‘highly selected’…

And operated in high volume centres with common high quality surgical pedigree. What is certain is that conducting ever increasingly hyper-selected Phase 2 trials is difficult to justify without any evidence of benefit to surgery.”

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Source: John Edwards/X