Translation of clinical trial outcomes to metastatic colorectal cancer patients in community practice

Abstract

Survival outcomes in routine clinical care for patients with metastatic colorectal cancer have markedly improved in recent years following the introduction of multiple new active therapies. The improved outcome of untreated patients suggests earlier diagnosis and improved supportive care may also be contributing to survival gains.

Wnt/catenin β1/microRNA 183 predicts recurrence and prognosis of patients with colorectal cancer

“…Globally, 900,000 additional cases of and 500,000 mortalities due to colorectal cancer are reported annually in 2012 (2). Globally, the incidence rate of colorectal cancer ranks second among lethal tumors, and threatens human health (3). Epidemiological studies have revealed that colon cancer-associated morbidity exhibits regional differences.…”

How accurate are medical oncologists’ impressions of management of metastatic colorectal cancer in Australia?

“…The addition of irinotecan and oxaliplatin to fluropyrimidine‐based palliative chemotherapy improved survival outcomes, with further gains following the introduction of biological agents including bevacizumab and the epidermal growth factor inhibitors . These improved survival outcomes have been shown to have translated into survival gains in routine clinical practice . Furthermore, liver resections – and somewhat more controversially – the use of adjuvant chemotherapy in this setting have also been incorporated into the treatment paradigm of mCRC.…”

Translation from clinical trials to routine practice: How to demonstrate community benefit

“…Questions about bias are often directed more at survival outcomes than patterns of care . Data interpretations for routine practice settings may be compromised by suboptimum data quality and completeness for potential confounders (as in this study where performance status data were incomplete). Lok et al .…”

“…in the APJCO December issue demonstrates the use of a clinical database for assessing research translation . It shows uptake of treatments proven to be effective in earlier clinical trials and improved survival for metastatic colorectal cancer at four major Melbourne hospitals . It is important as population benefits from trials depend on research translation.…”

“…Lok et al . show a favorable survival trend, both in patients not receiving as well as those receiving active treatment, indicating potential effects on results of unmeasured or poorly measured confounding factors …”