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Does enrollment in cancer trials improve survival?
Christopher J Chow1, Elizabeth B Habermann, Anasooya Abraham
1Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Journal of the American College of Surgeons
|February 19, 2013
Summary
Cancer clinical trial enrollment may improve patient survival, particularly for lung, colon, and breast cancers. However, favorable patient characteristics may also contribute to this observed survival benefit.
Area of Science:
- Oncology
- Clinical Trials
- Epidemiology
Background:
- Cancer clinical trials offer benefits, including guiding future treatment decisions.
- The independent impact of cancer trial enrollment on patient survival is understudied.
- This study hypothesized no association between cancer trial enrollment and survival outcomes.
Purpose of the Study:
- To investigate the association between cancer clinical trial enrollment and patient survival.
- To determine if trial participation independently impacts overall and cancer-specific mortality.
Main Methods:
- Utilized the California Cancer Registry (2002-2008) for 555,469 patients with solid organ tumors.
- Employed logistic regression for predictors of trial enrollment and Cox regression for survival analysis.
- Adjusted for covariates in multivariate survival analyses.
Main Results:
- Only 0.33% of the cohort enrolled in clinical trials.
- Trial participants were younger, more likely Hispanic, and had breast cancer.
- Enrollment predicted lower mortality, notably in lung, colon, and breast cancers.
Conclusions:
- Cancer trial enrollment was associated with reduced mortality in common solid organ cancers.
- Observed survival benefits may reflect both trial effects and favorable patient attributes.
- Future trial designs should be representative of the real-world cancer burden.
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