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Barbara Dourado
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OA04 - Improving Access and Outcomes in Lung Cancer Management (ID 898)
- Event: WCLC 2018
- Type: Oral Abstract Session
- Track: Nursing and Allied Professionals
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 10:30 - 12:00, Room 201 F
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OA04.01 - What is the Cost of a Strong Evidence for the Treatment of Advanced Non-Small Cell Lung Cancer? (ID 14410)
10:30 - 10:40 | Author(s): Barbara Dourado
- Abstract
- Presentation
Background
Evidence-based medicine was developed to guide medical decisions based upon the strongest scientific evidence available in the literature. However, large randomized clinical trials are expensive. In addition, new antineoplastic drugs development is also extremely expensive. Therefore, we hypothesized that the strongest evidence available nowadays comes from studies developed by the pharmaceutical industry.
a9ded1e5ce5d75814730bb4caaf49419 Method
We carried out a search on network databases for studies published between 2014 and 2017. We included only experimental studies that assessed the treatment for advanced or metastatic non-small cell lung cancer. All included studies were divided into two groups: studies funded by pharmaceutical industry and studies funded by other sources. The primary end point was to compare the evidence strength of each group. Secondary end points were to compare other aspects, such as the number of patients included by each group of studies and the number of innovative drugs studied by each group of studies.
4c3880bb027f159e801041b1021e88e8 Result
We found 1,502 studies and included 299 studies (154 sponsored by pharmaceutical industry and 145 funded by other sources). 52,988 patients were included in all studies (36,455 in studies sponsored by industry and 16,533 in studies with other funding sources; p < 0.001). The studies funded by pharmaceutical industry had the stronger evidence compared with studies with other sources of funding (p = 0.005). Moreover, studies sponsored by pharmaceutical industry studied more innovative therapies (72.4% versus 48.9%; p < 0.001) and had a higher proportion of open access manuscript (60.8% versus 43.9%; p = 0.004). Results are summarized in the table.
Parameter Industry Sponsored P value Yes
154 (100%)
No
145 (100%)Number of patients 36,455 16,533 <0.001 Mean N of patients 236.7 115.6 Line First 110 (71.4%) 94 (64.8%) 0.220 Second or more 44 (28.6%) 51 (35.2%) Biomarker Yes 55 (35.9%) 55 (37.9%) 0.723 No 98 (64.1%) 90 (62.1%) Innovative Tx Yes 110 (72.4%) 69 (48.9%) <0.001 No 42 (27.6%) 71 (51.1%) Phase I 20 (13%) 25 (17.2%) 0.409 II 101 (65.6%) 97 (66.9%) III 32 (20.8%) 21 (14.5%) IV 1 (0.6%) 2 (1.4%) Evidence Level 1 0 (0%) 1 (0.7%) 0.005 2 76 (49.4%) 52 (35.9%) 3 78 (50.6%) 87 (60%) 4 0 (0%) 5 (3.4%) Experimental Yes 35 (47.3%) 26 (50%) 0.765 Superiority No 39 (52.7%) 26 (50%) Open Access Yes 93 (60.8%) 61 (43.9%) 0.004 Article No 60 (39.2%) 78 (56.1%)
Studies funded by pharmaceutical industry had stronger evidence, tested more innovative therapies, and were more accessible to the readers compared with studies developed with other sources of funding. These findings may alert oncology cooperative groups to the need of more studies with more evidence strength.
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