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Lawson Eng
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OA10 - The Slow Pandemic – Tobacco Control in the Prevention of Lung Cancer (ID 170)
- Event: WCLC 2020
- Type: Oral
- Track: Risk Reduction and Tobacco Control
- Presentations: 1
- Moderators:
- Coordinates: 1/31/2021, 10:30 - 11:30, Scientific Program Auditorium
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OA10.03 - Reporting of Tobacco Use and Impact on Outcomes in Cancer Cooperative Group Clinical Trials: A Systematic Scoping Review (ID 3214)
10:30 - 11:30 | Presenting Author(s): Lawson Eng
- Abstract
- Presentation
Introduction
Continued smoking after a diagnosis of cancer negatively impacts cancer outcomes but the impact of tobacco on many innovative treatments have not yet been well established. Collecting and evaluating tobacco use in cancer clinical trials may advance understanding of the consequences of tobacco use on specific treatment modalities. We performed a systematic scoping review to evaluate how frequently tobacco use is reported in clinical trial participants and whether investigators evaluated the impact of continued tobacco use on trial outcomes in trials conducted by cancer cooperative clinical trials groups.
Methods
A comprehensive literature search was conducted in English to identify cancer cooperative group clinical trials published between January 1, 2017 and October 2019 using Medline, Epub Ahead of Print and In-Process & Other Non-Indexed Citations, Embase, Cochrane Central Register of Controlled Trials, all from the OvidSP platform. The search was restricted to adults, and clinical trials wherever possible. Eligible studies evaluated either systemic and/or radiation therapies, involved at least one cancer cooperative group, included > 100 adult patients and reported on at least one primary or secondary trial endpoint, which included overall survival (OS), disease/progression-free survival (DFS/PFS), response rates, toxicities/adverse events, or quality-of-life. Secondary analyses of previously published trials were excluded.
Results
Among 14843 identified studies, 91 studies representing 90 trials met inclusion criteria. 24% were phase II, 2% were phase II/III and 74% were phase III trials. Trial start dates ranged from 1995-2015 with most (29%) between 2007-2008; median trial sample size was 406 (range: 100-4994); 86% involved systematic therapy, while 35% involved radiation therapy; 14% were lung and 5% were head and neck trials. 51% of trials had a curative intent, 33% were palliative, and 16% involved hematologic cancers. 74 studies reported on OS, 73 DFS/PFS, and 88 toxicity/quality-of-life outcomes. 19 (21%) studies reported baseline tobacco use information, while two (2%) reported collecting follow-up tobacco use. Of those collecting baseline tobacco use, only 6 reported any analysis of the impact of tobacco on clinical outcomes. There was significant heterogeneity in the reporting of baseline tobacco use as 5 studies reported never/ever status, 10 reported never/ex-smoker/current smoker status, and 4 studies reported some measure of smoking intensity. Trials of tobacco-related (lung and head and neck) cancers were more likely to report baseline tobacco use compared to non-tobacco related cancers (83% vs 6%, p<0.001).
Conclusion
Few cancer cooperative group clinical trials report and analyze trial participants’ baseline tobacco use, and even fewer collect follow-up information. Significant heterogeneity exists in reporting tobacco use. Routine standardized collection and reporting of tobacco use both at baseline and follow-up in clinical trials should be implemented to enable investigators to evaluate the clinical impact of tobacco use on new cancer therapies.
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