Effect of Prior Cancer on Outcomes in Advanced Lung Cancer: Implications for Clinical Trial Eligibility and Accrual
Effect of Prior Cancer on Outcomes in Advanced Lung Cancer: Implications for Clinical Trial Eligibility and Accrual
复制标题
DOI：
10.1093/jnci/djv002
复制
发表时间：
2015-04-01
影响因子：
10.3
通讯作者：
Gerber, David E.
中科院分区：
文献类型：
--
作者：
Laccetti, Andrew L.;Pruitt, Sandi L.;Gerber, David E.
Background: Prior cancer is a common exclusion criterion in lung cancer trials. This practice reflects concerns that prior cancer may affect trial conduct or outcomes. However, the impact of prior cancer on survival in lung cancer is not known.Methods: We identified patients older than age 65 years with stage IV lung cancer diagnosed between 1992 and 2009 in the Surveillance, Epidemiology, and End Results-Medicare linked registry. Prior cancer was characterized by type, stage, and timing. All-cause and lung cancer-specific survival were compared between patients with and without prior cancer using propensity score-adjusted Cox regression.Results: Overall, 102 929 patients with stage IV lung cancer were identified, of whom 14.7% had a history of prior cancer. More than two-thirds (76.0%) of prior cancers were localized or regional stage; most were diagnosed five or fewer years prior to the lung cancer diagnosis. In propensity score-adjusted analysis, patients with prior cancer had better all-cause (hazard ratio [HR] = 0.93, 95% confidence interval [CI] = 0.91 to 0.94) and lung cancer-specific (HR = 0.81, 95% CI = 0.79 to 0.82) survival. In a simulated clinical trial-eligible population (age
