#How many days since january 5 2017 trial

Moreover, a Cox analysis of nearly 4000 propensity-matched pairs of patients demonstrated that adjuvant chemotherapy was associated with a lower mortality risk than surgery alone, including among patients who initiated adjuvant chemotherapy more than 8 weeks after surgery. The results demonstrated no hint of inferior survival among the patients who received chemotherapy in the later time period, beyond which we have data from clinical trials. Here, the study by Salazar and colleagues, 3 a retrospective analysis of survival among 12 473 postoperative patients with results captured in the National Cancer Database, and with the aforementioned criteria defining appropriate level of risk of recurrence, compared survival outcomes for patients who initiated adjuvant chemotherapy early (18-36 days), late (57-114 days), or at a time between these intervals.

Should an intervention with an established survival benefit be deferred in this setting? While we do not have prospective evidence to speak to this, absence of proof is not proof of absence.Įvery clinic day, oncologists and other physicians face the challenge of how far to extrapolate from the results of clinical trials with often narrowly defined clinic populations to a broader population of patients in our clinics. 2 In practice, this means that many patients who would otherwise be appropriate candidates for adjuvant chemotherapy do not present for consideration of treatment until later than best practices would recommend.

#How many days since january 5 2017 trial

A clinical trial directly comparing preoperative with postoperative chemotherapy for early-stage NSCLC also demonstrated an attrition rate of 34% for postoperative chemotherapy within the protocol-defined window of 6 to 7 weeks owing to a wide range of complicating factors. 1 As in many clinical settings, however, patients in real-world practice are not well represented by those on the relevant clinical trials, as those in the pivotal adjuvant trials are approximately a decade younger and with a near uniformly good performance status. The data from a wide range of prospective, randomized phase 3 trials are clear: There is a significant survival benefit from adjuvant cisplatin-based chemotherapy for patients with resected higher-risk non–small-cell lung cancer (NSCLC), often defined as node-positive and/or with the primary tumor measuring 4 cm or greater in diameter.

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