Comparison of outcomes between Hodgkin's lymphoma patients treated in and outside clinical trials: A study based on theEORTC‐Dutchlate effects cohort‐linked data

Abstract

Studies have shown higher survival rates for patients with Hodgkin lymphoma (HL) treated within clinical trials compared to patients treated outside clinical trials.However, endpoints are often limited to overall survival (OS). In this retrospective cohort study, we investigated the effect of trial participation on OS, the incidence of relapse, second cancer, and cardiovascular disease (CVD). The study population consisted of patients with HL, aged between 14 and 51 years at diagnosis, who started their treatment between 1962 and 2002 at three Dutch cancer centres. Patients were either included in the EORTC Lymphoma Group trials (H1-H9) or treated according to standard guidelines at the time. After adjusting for differences in baseline characteristics, trial participation was associated with longer OS (median OS: 29.4 years [95%CI: 27.0-31.6] for treatment inside trials versus 27.4 years [95%CI:26.0-28.5] for treatment outside trials, p = .046), a lower incidence of relapse (HR = 0.79, 95%CI: 0.63-0.98, p = .036) and a higher incidence of CVD (HR = 1.49, 95%CI: 1.23-1.79, p < .001). The trial effect for CVD was present only for patients treated before 1983. No evidence of differences in the incidence of second cancer was found. Consequently, essential results from clinical trials should be implemented into standard practice without undue delay.

Impact on costs and outcomes of multi-gene panel testing for advanced solid malignancies: a cost-consequence analysis using linked administrative data

“…Other potential explanations include the likely association of NGS panel testing with early palliative care referral and more intense multidisciplinary team involvement in the care of cancer patients which have been shown to improve disease outcomes. 23 Despite the comprehensive number of palliative care quality metrics analyzed, we acknowledge that additional end-of-life quality metrics such as preferred place of death were not captured in our work. 24 Despite these limitations, our results unveil several downstream effects of NGS beyond clinical trial or targeted therapies access.…”