Systematic evaluation of the efficacy-effectiveness gap of systemic treatments in metastatic nonsmall cell lung cancer

摘要: The divergence between clinical trial results and real-world outcomes is largely unknown for many cancer types. present study aims overall to assess the efficacy-effectiveness gap (difference in trials real world) systemic treatment metastatic nonsmall cell lung (NSCLC).All patients diagnosed with stage IV NSCLC 2008 2014 within a network of seven Dutch large teaching hospitals (Santeon) were studied. For every patient, an (EE) factor was calculated by dividing individual patients' survival (OS) pooled median OS assessed from respective treatment.From 2989 patients, 1214 (41%) started first-line treatment. all studied regimens, shorter than reported trials. Overall, EE 0.77 (95% CI 0.70-0.85; p<0.001). Real-world completed their plan less often proceeded frequently further lines These parameters together Eastern Cooperative Oncology Group performance status explained 35% variation factor.Survival treated chemotherapy or targeted therapy practice nearly one-quarter included Patients' status, earlier discontinuation fewer subsequent partly this difference.