Evidence map›Paper›PMID 34064995›Full record

ArticleCancers2021

Clinical Predictors of Early Trial Discontinuation for Patients Participating in Phase I Clinical Trials in Oncology.

Joeri A J Douma, Laurien M Buffart, Ramy Sedhom, Mariette Labots, Willemien C Menke-van der Houven van Oordt, Mikkjal Skardhamar, Anthony De Felice, Esther Lee, Divya Dharmaraj, Nilofer S Azad and 2 more

Open access · goldAbstract read
In one paragraph

Article in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Use of supportive care services and advance care planning among early phase oncology clinical trial participants.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Joeri A J DoumaCancer Center Amsterdam, Amsterdam University Medical Center, Department of Medical Oncology, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
Laurien M BuffartDepartment of Physiology, Radboudumc, 6525 GA Nijmegen, The Netherlands.
Ramy SedhomSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Mariette LabotsCancer Center Amsterdam, Amsterdam University Medical Center, Department of Medical Oncology, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
Willemien C Menke-van der Houven van OordtCancer Center Amsterdam, Amsterdam University Medical Center, Department of Medical Oncology, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
Mikkjal SkardhamarCancer Center Amsterdam, Amsterdam University Medical Center, Department of Medical Oncology, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
Anthony De FeliceSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.ORCID 0000-0002-8604-181X
Esther LeeSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Divya DharmarajSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Nilofer S AzadSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Michael A CarducciSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Henk M W VerheulCancer Center Amsterdam, Amsterdam University Medical Center, Department of Medical Oncology, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.ORCID 0000-0001-5981-922X
Sidney Kimmel Comprehensive Cancer Center · USAmsterdam University Medical Centers · NLRadboud University Nijmegen · NL

Funding

The Johns Hopkins Translational Science Team for the ET-CTNUM1CA186691 · NCI · JOHNS HOPKINS UNIVERSITY · PI Jan Hendrik Beumer, Michael A Carducci · 2014 to 2026
$21.9M
NCI NIH HHS UM1 CA186691
6 · The paper itself

Abstract

Despite stringent eligibility criteria for trial participation, early discontinuation often occurs in phase I trials. To better identify patients unlikely to benefit from phase I trials, we investigated predictors for early trial discontinuation. Data from 415 patients with solid tumors who participated in 66 trials were pooled for the current analysis. Early trial discontinuation was defined as (i) trial discontinuation within 28 days after start of treatment or (ii) discontinuation before administration of the first dosage in eligible patients. Multilevel logistic regression analyses were conducted to identify predictors for early trial discontinuation. Eighty-two participants (20%) demonstrated early trial discontinuation. Baseline sodium level below the lower limit of normal (OR = 2.95, 95%CI = 1.27-6.84), elevated alkaline phosphatase level > 2.5 times the upper limit of normal (OR = 2.72, 95%CI = 1.49-4.99), performance score ≥ 1 (OR = 2.07, 95%CI = 1.03-4.19) and opioid use (OR = 1.82, 95%CI = 1.07-3.08) were independent predictors for early trial discontinuation. Almost 50% of the patients with hyponatremia and all four patients in whom all four predictors were present together discontinued the trial early. Hyponatremia, elevated alkaline phosphatase level, performance score ≥ 1 and opioid use were identified as significant predictors for early trial discontinuation. Hyponatremia was the strongest predictor and deserves consideration for inclusion in eligibility criteria for future trials.

Indexed as

clinical predictorsdrug developmentearly trial discontinuationhyponatremiaphase I trial

Identifiers

PMID34064995
PMCPMC8151105
OpenAlexW3163884280

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.