Ambulatory Routine Care in Oncology in Germany: Real-World Survival Data.

IF 2 4区 医学 Q3 ONCOLOGY Oncology Research and Treatment Pub Date : 2024-01-01 Epub Date: 2024-03-15 DOI:10.1159/000536652
Norbert Marschner, Wolfgang Knauf
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Abstract

Introduction: Survival data reported by randomised controlled trials are collected in a highly selected patient population and can thus only be transferred to a limited extent to real-world patients: the patients in routine care are mostly older, present with more comorbidities and a worse general state of health. This so-called efficacy-effectiveness gap typically results in inferior survival data in routine healthcare.

Methods: Six prospective clinical tumour registries recruited a total of 11,679 patients receiving systemic therapy in haemato-oncological practices in Germany between 2006 and 2020. For these patients with advanced colorectal cancer, breast cancer, lung cancer, pancreatic cancer, renal cell cancer, and lymphatic neoplasms, overall survival was analysed. A comprehensive literature search was performed to identify suitable pivotal randomised controlled trials.

Results: Median overall survival of patients treated in German routine care, with advanced colorectal, breast, lung, and pancreatic cancer, as well as with diffuse large B-cell lymphoma and multiple myeloma, is not shorter than the respective survival data reported in trials. Patients with advanced renal cell carcinoma, chronic lymphocytic leukaemia, or indolent non-Hodgkin lymphoma showed slightly lower survival rates compared to clinical trials.

Conclusions: Despite less favourable patient characteristics, survival data from patients with cancer treated in ambulatory routine care in Germany are in range with results from randomised controlled studies.

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德国非住院常规肿瘤治疗:真实世界的生存数据。
简介随机对照试验报告的存活率数据是在经过严格筛选的患者群体中收集的,因此只能在一定程度上应用于现实世界中的患者:常规护理中的患者大多年龄较大,合并症较多,总体健康状况较差。这种所谓的疗效差距通常会导致常规医疗的生存数据较差:方法:2006 年至 2020 年间,六个前瞻性临床肿瘤登记处共招募了 11679 名在德国血液肿瘤诊所接受系统治疗的患者。对这些晚期结直肠癌、乳腺癌、肺癌、胰腺癌、肾细胞癌和淋巴肿瘤患者的总生存期进行了分析。为了找到合适的关键性随机对照试验,我们进行了全面的文献检索:结果:在德国接受常规治疗的晚期结直肠癌、乳腺癌、肺癌、胰腺癌以及弥漫大 B 细胞淋巴瘤和多发性骨髓瘤患者的中位总生存期并不比试验报告的相应生存期数据短。与临床试验相比,晚期肾细胞癌、慢性淋巴细胞白血病或非霍奇金淋巴瘤患者的生存率略低:结论:尽管患者的特征不太理想,但在德国接受非住院常规治疗的癌症患者的生存数据与随机对照研究的结果相符。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
84
期刊介绍: With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.
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