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Improving the Lung Cancer Clinical Trial Development by Incorporating Competing Risk Factors
- Source :
- BioMed Research International, BioMed Research International, Vol 2021 (2021)
- Publication Year :
- 2021
-
Abstract
- Introduction. Distinct from other diseases, as cancer progresses, both the symptoms and treatments evolve, resulting in a complex, time-dependent relationship. Many competing risk factors influence the outcome of cancer. An improved method was used to evaluate the data from 6 non-small-cell lung cancer (NSCLC) clinical trials combined in our center since 2016 to deal with the bias caused by competing risk factors. Material and Methods. Data of 118 lung cancer patients were collected from 2016 to 2020. Fine and Gray’s model for competing risk was used to evaluate survival of different treatment group compares with the classic survival analysis model. Results. Immunotherapy had better progression-free survival than chemotherapy. (HR: 0.62, 95% CI: 0.41-0.95, p = 0.0260 ). However, there were no significant differences in patients who withdrew due to treatment-related adverse events from different groups. ( Z = 0.0508 , p = 0.8217 ). The PD-1/PD-L1 inhibitors in our study did not significantly improve overall survival compared with chemotherapy (HR:0.77, 95% CI:0.48-1.24, p = 0.2812 ), estimated 1-year overall survival rates were 55% and 46%, and 3-year overall survival rates were 17% and 10%, respectively. Conclusion. When the outcome caused by competing risk exists, the corresponding competing risk model method should be adopted to eliminate the bias caused by the classic survival analysis.
- Subjects :
- Oncology
Male
medicine.medical_specialty
Lung Neoplasms
Article Subject
medicine.medical_treatment
Kaplan-Meier Estimate
Competing risks
General Biochemistry, Genetics and Molecular Biology
Risk Factors
Internal medicine
medicine
Humans
Adverse effect
Lung cancer
Survival analysis
Aged
Chemotherapy
Clinical Trials as Topic
General Immunology and Microbiology
business.industry
Incidence
Cancer
General Medicine
Immunotherapy
Middle Aged
medicine.disease
Progression-Free Survival
Clinical trial
Disease Progression
Medicine
Female
business
Research Article
Subjects
Details
- ISSN :
- 23146141
- Volume :
- 2021
- Database :
- OpenAIRE
- Journal :
- BioMed research international
- Accession number :
- edsair.doi.dedup.....d8b9d92c1aeb301a8a836fe66d22100a