Dose escalation in stage III non–small-cell lung cancer: Patients agree with the clinical results
Menée à partir de questionnaires auprès de 313 patients atteints d'un cancer du poumon non à petites cellules de stade III et non résécable, cette étude multicentrique américano-canadienne évalue, en fonction de la dose de rayonnements reçus, leur qualité de vie trois mois et douze mois après le début d'un traitement combinant une radiothérapie et une chimiothérapie par carboplatine-paclitaxel avec ou sans cétuximab
As we conduct clinical research to continue to “move the dial” of progress against lung cancer, it has become increasingly important to consider the patient’s perspective alongside that of more standard efficacy and safety end points. Besides the obvious reason of patient centricity, there are several compelling clinical reasons to do so. In this issue of JAMA Oncology, the article by Movsas and colleagues1 provides us with more evidence to illustrate the importance of the patient’s perspective on efficacy and safety in clinical trials, and especially the importance of studies in advanced disease. The results reaffirm a few principles of quality-of-life measurement in advanced tumor oncology that can now be considered teachable facts, supported by robust results, reproduced in multiple studies, using various questionnaires. Three such facts are (1) quality-of-life reports taken at the start of a new therapy for advanced disease are predictive of survival; (2) clinician-rated toxicity on the Common Terminology Criteria for Adverse Events (CTCAE) grading system underestimates the adverse effects of treatments on patients’ lives; and (3) dose escalation, whether chemotherapeutic or radiotherapeutic, has predictable, deleterious effects on quality of life, as reported on a well-validated lung cancer questionnaire. To frame these “facts,” I will discuss them in the context of the article by Movsas et al.1
JAMA Oncology , commentaire en libre accès, 2014