ArticleJournal of the National Cancer Institute2015
Generalizability of trial results to elderly Medicare patients with advanced solid tumors (Alliance 70802).
Open access · greenAbstract read
In one paragraph
Article in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
15.9field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 31 citations in OpenAlex.
- Estimation of Population Average Treatment Effects in the FIRST Trial: Application of a Propensity Score-Based Stratification Approach.Health services research · 2018Trial
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- Efficacy and Safety of Chemotherapy in Elderly Patients with Unresectable Pancreatic Cancer.Journal of clinical medicine · 2023Article
- A novel nomogram for predicting long-term heart-disease specific survival among older female primary breast cancer patients that underwent chemotherapy: A real-world data retrospective cohort study.Frontiers in public health · 2022Article
- Treatment optimization of locally advanced and metastatic pancreatic cancer (Review).International journal of oncology · 2021Review
- Estimated direct costs of non-small cell lung cancer by stage at diagnosis and disease management phase: A whole-disease model.Thoracic cancer · 2021Article
- Modified FOLFIRINOX in pancreatic cancer patients Age 75 or older.Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2020Article
- Geriatric oncology health services research: Cancer and Aging Research Group infrastructure core.Journal of geriatric oncology · 2020Article
- Diagnostic Assessment of Assumptions for External Validity: An Example Using Data in Metastatic Colorectal Cancer.Epidemiology (Cambridge, Mass.) · 2019Article
- Recruitment practices for U.S. minority and underserved populations in NRG oncology: Results of an online survey.Contemporary clinical trials communications · 2018Article
- Evaluation of Treatment Patterns and Survival Outcomes in Elderly Pancreatic Cancer Patients: A Surveillance, Epidemiology, and End Results-Medicare Analysis.The oncologist · 2018Article
- Clinical decision making in cancer care: a review of current and future roles of patient age.BMC cancer · 2018Review
- Being present: oncologists' role in promoting advanced cancer patients' illness understanding.Cancer medicine · 2018Article
- Targeted Therapies in the Management of Ovarian Cancer: A Focus on Older Patients.Drugs & aging · 2017Review
- Survival after recurrence of stage I-III breast, colorectal, or lung cancer.Cancer epidemiology · 2017Article
- Survival and Toxicity After Cisplatin Plus Etoposide Versus Carboplatin Plus Etoposide for Extensive-Stage Small-Cell Lung Cancer in Elderly Patients.Journal of oncology practice · 2016Article
- Management of pancreatic cancer in the elderly.World journal of gastroenterology · 2016Review
- From evidence to clinical practice in blood and marrow transplantation.Blood reviews · 2015Review
- Chemotherapy Use, Performance Status, and Quality of Life at the End of Life.JAMA oncology · 2015Article
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 1 country.
Elizabeth B LamontMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ). lamont@hcp.med.harvard.edu.
Richard L SchilskyMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Yulei HeMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Hyman MussMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Harvey Jay CohenMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Arti HurriaMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Ashley MeilleurMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Hedy L KindlerMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Alan VenookMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Rogerio LilenbaumMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Harvey NiellMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Richard M GoldbergMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Steven JoffeMassachusetts General Hospital Cancer Center, Boston, MA (EL); Departments of Medicine, and Health Care Policy, Harvard Medical School, Boston, MA (EL, YH, AM); American Society of Clinical Oncology, Alexandria, VA (RLS); Department of Medicine, University of North Carolina, Chapel Hill, NC (HM); Department of Medicine, Duke University, Durham, NC (HJC); City of Hope, Duarte, CA (AH); Department of Medicine, University of Chicago, Chicago, IL (HLK); Department of Medicine, University of California San Francisco, San Francisco, CA (AV); Yale Cancer Center, New Haven, CT (RL); Department of Medicine, the University of Tennessee, Memphis, TN (HN); Department of Medicine, Ohio State University, Columbus, OH (RMG); Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SJ).
Alliance for Clinical Trials in Oncology
Harvard University Press · USAmerican Society of Clinical Oncology · USCity Of Hope National Medical Center · USDuke University · USThe Ohio State University · USUniversity of California, San Francisco · USUniversity of Chicago · USUniversity of Tennessee Health Science Center · USYale Cancer Center · US
Funding
CANCER AND LEUKEMIA GROUP B MINORITY SATELLITE SUPPLEMENU10CA031946 · NCI · UNIVERSITY OF CHICAGO · PI BERTAGNOLLI, MONICA M · 1985 to 2013
$158.4MCollaborations and NCORP Collective ManagementUG1CA189823 · NCI · MAYO CLINIC ROCHESTER · PI Evanthia Galanis, Olwen Hahn · 2014 to 2026
$120.6MCANCER &LEUKEMIA GROUP B STATISTICAL CENTERU10CA033601 · NCI · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI SARGENT, DANIEL J. · 1985 to 2013
$69.4MRe-Engineering Translational Research at the University of ChicagoUL1TR000430 · NCATS · UNIVERSITY OF CHICAGO · PI SOLWAY, JULIAN · 2012 to 2016
$20.2MOSU as Network Lead Academic Participating Site for the NCI NCTNU10CA180850 · NCI · OHIO STATE UNIVERSITY · PI BLUM, KRISTIE A, CHAKRAVARTI, ARNAB · 2014 to 2018
$6.8MNCTN Lead Academic Participating Sites ApplicationU10CA180838 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CAREY, LISA A · 2014 to 2018
$2.8MPopulation-Based Assessment of Cancer Trial Generalizability in the ElderlyR01CA132900 · NCI · HARVARD MEDICAL SCHOOL · PI LAMONT, ELIZABETH B · 2008 to 2012
$2.0MDo Medicare Claims Measure Chemotherapy Use and OutcomesK07CA093892 · NCI · UNIVERSITY OF CHICAGO · PI LAMONT, ELIZABETH B · 2002 to 2006
$653kNCATS NIH HHS UL1 TR000430NCI NIH HHS CA31946NCI NIH HHS CA33601NCI NIH HHS K07 CA9389204NCI NIH HHS R01 CA132900NCI NIH HHS U10 CA180838NCI NIH HHS U10 CA180850NCI NIH HHS UG1 CA189823
Abstract
backgroundIn the United States, patients who enroll in chemotherapy trials seldom reflect the attributes of the general population with cancer, as they are often younger, more functional, and have less comorbidity. We compared survival following three chemotherapy regimens according to the setting in which care was delivered (ie, clinical trial vs usual care) to determine the generalizability of clinical trial results to unselected elderly Medicare patients.
methodsUsing SEER-Medicare data, we estimated survival for elderly patients (ie, age 65 years or older, n = 14097) with advanced pancreatic or lung cancer following receipt of one of three guideline-recommended first-line chemotherapy regimens. We compared their survival to that of similarly treated clinical trial enrollees, without age restrictions, with the same diagnosis and stage (n = 937). All statistical tests were two-sided.
resultsTrial patients were 9.5 years younger than elderly Medicare patients. Medicare patients were more often white and tended to live in areas of greater educational attainment than trial enrollees. For each tumor type, Medicare patients who were 75 years or older had median survivals that were six to eight weeks shorter than those of trial patients (4.3 vs 5.8 months following treatment with single agent gemcitabine for advanced pancreatic cancer, P = .03; 7.3 vs 8.9 months following treatment with carboplatin and paclitaxel for stage IV non-small cell lung cancer, P = .91; 8.2 vs 10.2 months following treatment with CDDP/ VP16 for extensive stage small cell lung cancer, P ≤ .01), whereas younger Medicare patients had survival times that were similar to those of trial patients.
conclusionsResults of clinical trials for advanced pancreatic cancer and lung cancers tended to correctly estimate survival for Medicare patients aged 65 to 74 years, but to overestimate survival for older Medicare patients by six to eight weeks. These estimates of Medicare patients' survival may aid subsequent patients and their oncologists in treatment decision-making.
Indexed as
Clinical Trials as TopicAgedAged, 80 and overAge FactorsAntineoplastic Combined Chemotherapy ProtocolsEducational StatusFemaleHumansKaplan-Meier EstimateLung NeoplasmsMaleMedicareMiddle AgedPancreatic NeoplasmsPrognosisSEER Program
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