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Alanda Alves



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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): Alanda Alves

      • Abstract
      • Presentation
      • Slides

      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%)

      8eea62084ca7e541d918e823422bd82e Conclusion

      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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