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Systematic evaluation of the efficacy-effectiveness gap of systemic treatments in extensive disease small cell lung cancer
- Source :
- Pharmacoepidemiology and Drug Safety, 30(4), 445. John Wiley and Sons Ltd, Pharmacoepidemiology and Drug Safety, 30(4). Wiley
- Publication Year :
- 2021
-
Abstract
- Purpose The aim of this study is to assess how clinical outcomes in real-world (effectiveness) correspond to the outcomes in clinical trials (efficacy) of systemic treatments for extensive disease small cell lung cancer (ED SCLC).Methods All patients diagnosed with ED SCLC between 2008 and 2014 in six Dutch large teaching hospitals (Santeon network) were identified and followed-up from date of diagnosis until death or end of data collection. For every patient, an efficacy-effectiveness factor (EE factor) was calculated by dividing individual patients' overall survival (OS) by the pooled median OS assessed from clinical trials with the respective treatment.Results From 792 diagnosed patients, 568 (72%) started with first-line treatment. Overall, the median EE factor was 0.79 (P = 2) and a higher age at diagnosis (age >= 65 years) were independent predictors for a lower EE factor. The EE gap was 43% in patients with both age >= 65 years and ECOG >= 2 (EE factor 0.57). The mean age and the proportion of patients with ECOG >= 2 in real-world were different from those in clinical trials (mean age of 66 versus 62 years, and ECOG >= 2 25% versus 17%; both P Conclusion OS of patients with ED SCLC treated with systemic therapy in real-world practice is 21% shorter than for patients included in trials. Age at diagnosis and performance status partly explain this gap.
- Subjects :
- medicine.medical_specialty
real-world
Lung Neoplasms
Epidemiology
world
efficacy
CISPLATIN PLUS ETOPOSIDE
MULTICENTER
effectiveness
PLACEBO-CONTROLLED TRIAL
030226 pharmacology & pharmacy
Systemic therapy
survival
03 medical and health sciences
DOUBLE-BLIND
pharmacotherapy
0302 clinical medicine
Pharmacotherapy
ETOPOSIDE/CISPLATIN
Internal medicine
RANDOMIZED-PHASE-III
CYCLOPHOSPHAMIDE
Taverne
medicine
Humans
In patient
Poor performance status
Pharmacology (medical)
030212 general & internal medicine
Aged
Retrospective Studies
CARBOPLATIN
Performance status
Extensive Disease
business.industry
real‐
OPEN-LABEL
Small Cell Lung Carcinoma
Clinical trial
1ST-LINE TREATMENT
Non small cell
small cell lung cancer
business
Subjects
Details
- Language :
- English
- ISSN :
- 10538569
- Database :
- OpenAIRE
- Journal :
- Pharmacoepidemiology and Drug Safety, 30(4), 445. John Wiley and Sons Ltd, Pharmacoepidemiology and Drug Safety, 30(4). Wiley
- Accession number :
- edsair.doi.dedup.....a75caf494e5bdd3972d65efc1cd2b049