Evidence map›Paper›PMID 35687964›Full record

ArticleCurrent problems in cancer2022

Optimizing the use of adjuvant chemotherapy in non-small cell lung cancer patients with comorbidities.

Stacyann Bailey, Qian Wang, Chung Yin Kong, Kimberly Stone, Rajwanth Veluswamy, Susan E Bates, Cardinale B Smith, Juan P Wisnivesky, Keith Sigel

Open access · greenAbstract read
In one paragraph

Article in Current problems in cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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

9 authors at 2 institutions in 1 country.

Stacyann BaileyDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: stacyann.bailey@mountsinai.org.
Qian WangDivision of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY.
Chung Yin KongDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Kimberly StoneDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Rajwanth VeluswamyDivision of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY.
Susan E BatesJames J. Peters VA Medical Center, Bronx, NY; Columbia University Irving Medical Center, New York, NY.
Cardinale B SmithDivision of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY.
Juan P WisniveskyDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Keith SigelDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Icahn School of Medicine at Mount Sinai · USColumbia University Irving Medical Center · US

Funding

Training Program in Cancer Prevention and Control for Priority PopulationsT32CA225617 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Guy H Montgomery, JUAN P WISNIVESKY · 2018 to 2026
$2.6M
NCI NIH HHS T32 CA225617
6 · The paper itself

Abstract

Veterans with locoregional non-small cell lung cancer (NSCLC) may benefit from adjuvant chemotherapy. However, comorbidities and other factors may impact the harms and benefits of this treatment. Here, we identified the optimal indications for adjuvant chemotherapy in Veterans with NSCLC, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), and/or coronary artery disease (CAD). We used data from randomized controlled trials (RCTs) and Veterans Administration (VA) databases to enhance a simulation model. Then, we conducted in-silico RCTs comparing adjuvant chemotherapy vs observation among Veterans with stage II-IIIA NSCLC. Among Veterans without COPD or CKD, adjuvant chemotherapy was the optimal strategy regardless of the presence or absence of CAD except for patients >70 years with squamous cell carcinoma. Conversely, most veterans without COPD but with CKD were optimally managed with observation. Veterans with COPD but without CKD, benefited from adjuvant chemotherapy if they were ≤70 years with stage II-IIIA adenocarcinoma or <60 years with stage II-IIIA squamous cell carcinoma. Adjuvant chemotherapy was only beneficial for Veterans with both COPD and CKD among stage II-IIIA adenocarcinoma <60 years of age. Veterans with stages II-IIIA squamous cell carcinoma, COPD, and CKD were optimally managed with observation. Many Veterans with comorbidities are optimally managed with observation post-surgical resection. However, we also identified several groups of Veterans whom the benefits of adjuvant chemotherapy outweighed the risks of early toxicity. Our findings could inform patient-provider discussions and potentially reduce physicians' uncertainty about the role of adjuvant chemotherapy in this population.

Indexed as

AdenocarcinomaCarcinoma, Non-Small-Cell LungCarcinoma, Squamous CellLung NeoplasmsPulmonary Disease, Chronic ObstructiveRenal Insufficiency, ChronicAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantHumansNeoplasm StagingRandomized Controlled Trials as TopicAdjuvant chemotherapyComorbiditiesNon-small cell lung cancerVeterans

Identifiers

PMID35687964
PMCPMC9276637
OpenAlexW4281261904

What OpenQuestion holds

Textmetadata
LicenceTDM
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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.