Clinical Trial Participation Is Associated With Improved Outcome in Women With Ovarian Cancer

Robinson, William R.; Ritter, J.; Rogers, April S.; Tedjarati, Sean S.; Lieberenz, Christy

doi:10.1111/igj.0b013e31819a1ce8

Cited by 22 publications

(14 citation statements)

References 23 publications

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“…Due to the distinct nature of women's health we focused solely on this disease area and within this subgroup analyses we observed an effect not previously seen in overall syntheses. A retrospective study of a regional cancer centre in the USA found clinical trial participation to improve significantly the survival of women with ovarian cancer compared with non‐participants (median 46 versus 25 months, 95% CI 1.03–2.15 months, P = 0.03) . That paper, though not part of our meta‐analysis, reached the same conclusion as ours.…”

Section: Discussionsupporting

confidence: 79%

“…A retrospective study of a regional cancer centre in the USA found clinical trial participation to improve significantly the survival of women with ovarian cancer compared with non-participants (median 46 versus 25 months, 95% CI 1.03-2.15 months, P = 0.03). 62 That paper, though not part of our meta-analysis, reached the same conclusion as ours.…”

Section: Strengths and Limitationssupporting

confidence: 79%

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Participation in clinical trials improves outcomes in women's health: a systematic review and meta‐analysis

Nijjar

D’Amico

Wimalaweera³

et al. 2017

BJOG

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Background Previous reviews examining the effect of participation in trials on outcomes have not consistently shown benefit. Obstetrics and gynaecology is a unique disease area posing challenges for both researchers and patients.Objectives To determine whether participation in randomised controlled trials (RCTs), compared with non-participation, has a beneficial effect on women's health.Search strategy Medline, Embase, the Cochrane Library, and PsycInfo were searched up to December 2015.Selection criteria We selected studies that reported the same clinical outcomes for participants in a women's health RCT and a comparable non-participant cohort.Data collection and analysis Data were extracted on quality, characteristics and study results. Outcomes were compared using logistic regression.Main results There were 21 relevant studies (20 160 women, 4759 outcome events). Trial participants, compared with nonparticipants, had 25% better odds of improved outcomes on average (OR 0.75; 95% CI 0.64-0.87; I 2 = 64.3%). The beneficial effect of participating in a trial was larger in comparisons where: RCTs were of high quality (OR 0.62; 95% CI 0.50-0.76) versus low (OR 0.92; 95% CI 0.74-1.16); and RCT intervention was not available to non-participants (OR 0.57; 95% CI 0.47-0.69) versus when it was (OR 1.13; 95% CI 0.89-1.44). The effect of trial participation was not influenced by effect size within the RCT (P = 0.48), whether funding was received or not (P = 0.13), whether non-participants received any treatment or not (P = 0.49), and the quality of the comparison of RCT participants with non-participants (P = 0.88).Conclusions Women participating in RCTs on average experienced better outcomes compared with those outside trials.Keywords Neonate, randomised, systematic review, trial participation, women's health.Tweetable abstract Participants in obstetric and gynaecology RCTs experience better outcomes compared with nonparticipants.Please cite this paper as: Nijjar SK, D'Amico MI, Wimalaweera NA, Cooper NAM, Zamora J, Khan KS. Participation in clinical trials improves outcomes in women's health: a systematic review and meta-analysis.

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Section: Discussionsupporting

confidence: 79%

Section: Strengths and Limitationssupporting

confidence: 79%

Participation in clinical trials improves outcomes in women's health: a systematic review and meta‐analysis

Nijjar

D’Amico

Wimalaweera³

et al. 2017

BJOG

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“…Affluent individuals possess greater economic resources and social capital, which enable them to avail themselves of the treatment advances associated with better cancer survival [39,40]. In addition, individual-level affluence is associated with private health insurance [73], which is associated in turn with greater access to gynecologic oncologists [74] and participation in clinical trials [75], factors that also result in improved ovarian cancer survival [76,77]. …”

Section: Discussionmentioning

confidence: 99%

The influence of neighborhood socioeconomic status and race on survival from ovarian cancer: a population-based analysis of Cook County, Illinois

Brewer

Peterson

Davis

et al. 2015

Annals of Epidemiology

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Purpose Despite significant improvements in treatment for ovarian cancer, survival is poorer for non-Hispanic black (NHB) women compared to non-Hispanic white (NHW) women. Neighborhood socioeconomic status (SES) has been implicated in racial disparities across a variety of health outcomes and may similarly contribute to racial disparities in ovarian cancer survival. The purpose of this analysis is to assess the influence of neighborhood SES on NHB-NHW survival differences after accounting for differences in tumor characteristics and in treatment. Methods Data were obtained from 2432 women (443 NHB and 1989 NHW) diagnosed with epithelial ovarian cancer in Cook County, Illinois between 1998 and 2007. Neighborhood (i.e., census tract) SES at the time of diagnosis was calculated for each woman using two well-established composite measures of affluence and disadvantage. Cox proportional hazard models measured the association between NHB race and survival after adjusting for age, tumor characteristics, treatment, year of diagnosis, and neighborhood SES. Results There was a strong association between ovarian cancer survival and both measures of neighborhood SES (P < .0001 for both affluence and disadvantage). After adjusting for age, tumor characteristics, treatment, and year of diagnosis, NHB were more likely than NHW to die of ovarian cancer (hazard ratio [HR] = 1.47, 95% confidence interval [CI]: 1.28–1.68). The inclusion of neighborhood affluence and disadvantage into models separately and together attenuated this risk (HRaffluence = 1.37, 95% CI: 1.18 –1.58; HRdisadvantage = 1.28, 95% CI: 1.08–1.52; and HRaffluence + disadvantage = 1.28, 95% CI: 1.08–1.52. Conclusions Neighborhood SES, as measured by composite measures of affluence and disadvantage, is a predictor of survival in women diagnosed with ovarian cancer in Cook County, Illinois and may contribute to the racial disparity in survival.

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“…They may be especially important in the context of ovarian cancer (OC), a disease characterized by late-stage diagnosis [2], persistently high mortality rates [3,4], and high rates of drug resistance and tumor recurrence [2]. Clinical trials may expand the number of available treatment options for OC patients [5,6] while advancing scientific discovery.…”

Section: Introductionmentioning

confidence: 99%

Patient and family member perspectives on searching for cancer clinical trials: A qualitative interview study

Ridgeway

Asiedu

Carroll

et al. 2017

Patient Education and Counseling

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Objective Clinical trials are vital in the context of ovarian cancer and may offer further treatment options during disease recurrence, yet enrollment remains low. Understanding patient and family member experiences with identifying trials can inform engagement and education efforts. Methods Interviews were conducted with 33 patients who had experience with clinical trial conversations and 39 nominated family members. Thematic analysis examined experiences and generated findings for clinical practice. Results Trial conversations with providers at diagnosis were uncommon and often overwhelming. Most participants delayed engagement until later in the disease course. With hindsight, though, some wished they considered trials earlier. Difficulty identifying appropriate trials led some to defer searching to providers, but then they worried about missed opportunities. Most family members felt unqualified to search. Conclusion Trial conversations during clinical encounters should start early and include specifying search responsibilities of providers, patients, and family. Patients and family members can be engaged in searches but need guidance. Practice Implications Trials should be discussed throughout the disease course, even if patients are not ready to participate or are not making a treatment decision. Education should focus on identifying trials that meet search criteria. Transparency regarding each individual's role in identifying trials is critical.

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Clinical Trial Participation Is Associated With Improved Outcome in Women With Ovarian Cancer

Cited by 22 publications

References 23 publications

Participation in clinical trials improves outcomes in women's health: a systematic review and meta‐analysis

Participation in clinical trials improves outcomes in women's health: a systematic review and meta‐analysis

The influence of neighborhood socioeconomic status and race on survival from ovarian cancer: a population-based analysis of Cook County, Illinois

Patient and family member perspectives on searching for cancer clinical trials: A qualitative interview study

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