Piotr Wysocki: Does participation in clinical trials improve patients’ outcomes?
Piotr Wysocki recently posted on LinkedIn:
“Iskander R et al. conducted a systematic review and meta-analysis to determine whether participation in cancer clinical trials was associated with greater survival benefit compared with routine practice.
The meta-analysis included 39 publications, 85 trial participants, and routine care patient comparisons. The meta-analysis revealed a statistically significant overall survival benefit for trial participants (HR, 0.76 [95% CI, 0.69-0.82]) when all studies
were pooled, regardless of design or quality.
However, survival benefits disappeared when only high-quality studies were pooled(HR, 0.91 [95% CI, 0.80-1.05]). They also disappeared when estimates were adjusted for potential publication bias (HR, 0.94 [95% CI, 0.86-1.03]).
The study by Iskander R et al. demonstrates that participation in clinical trials is not associated with improved outcomes. This is probably true only for patients treated in an ideal world where all the best standard therapies are easily accessible and reimbursed.
In fact, in the systematic review, approx. 80% of studies were conducted in North America and Australia, where routine care patients have almost unrestricted access to novel therapies, while approx. 20% of studies were conducted in Europe and Asia, where considerable differences in drug accessibility exist.
Therefore, the conclusions from the study by Iskander R et al. must be treated with caution because they do not seem to reflect actual benefits from clinical trial participation of patients treated beyond ideal world settings. ”
Survival Benefit Associated With Participation in Clinical Trials of Anticancer Drugs
Authors: Renata Iskander, Hannah Moyer, Karine Vigneault, Salaheddin M. Mahmud, MD, Jonathan Kimmelman
Source: Piotr Wysocki/LinkedIn
Piotr Wysocki leads the Clinical Oncology Department at University Hospital and the Faculty of Oncology at Jagiellonian University-Medical College in Krakow, Poland. As an advisor to the Polish Ministry of Health, he shapes the national cancer strategy.
His clinical expertise spans the systemic treatment of breast, gynecologic, and genitourinary cancers, with a focus on developing innovative metronomic chemotherapy-based therapies for advanced cancer patients who have undergone prior treatment.
Read other posts by Piotr Wysocki published on OncoDaily.