title: Treatment success in cancer: industry compared to publicly sponsored randomized controlled trials.
abstract: OBJECTIVE
  To assess if commercially sponsored trials are associated with higher success rates than publicly-sponsored trials.
  
  
  METHODS
  We undertook a systematic review of all consecutive, published and unpublished phase III cancer randomized controlled trials (RCTs) conducted by GlaxoSmithKline (GSK) and the NCIC Clinical Trials Group (CTG). We included all phase III cancer RCTs assessing treatment superiority from 1980 to 2010. Three metrics were assessed to determine treatment successes: (1) the proportion of statistically significant trials favouring the experimental treatment, (2) the proportion of the trials in which new treatments were considered superior according to the investigators, and (3) quantitative synthesis of data for primary outcomes as defined in each trial.
  
  
  RESULTS
  GSK conducted 40 cancer RCTs accruing 19,889 patients and CTG conducted 77 trials enrolling 33,260 patients. 42% (99%CI 24 to 60) of the results were statistically significant favouring experimental treatments in GSK compared to 25% (99%CI 13 to 37) in the CTG cohort (RR = 1.68; p = 0.04). Investigators concluded that new treatments were superior to standard treatments in 80% of GSK compared to 44% of CTG trials (RR = 1.81; p<0.001). Meta-analysis of the primary outcome indicated larger effects in GSK trials (odds ratio = 0.61 [99%CI 0.47-0.78] compared to 0.86 [0.74-1.00]; p = 0.003). However, testing for the effect of treatment over time indicated that treatment success has become comparable in the last decade.
  
  
  CONCLUSIONS
  While overall industry sponsorship is associated with higher success rates than publicly-sponsored trials, the difference seems to have disappeared over time.
authors.affiliation: Center for Evidence-Based Medicine and Health Outcomes Research, Tampa, Florida, USA. bdjulbeg@health.usf.edu
authors.forename: Benjamin
authors.initials: B
authors.lastname: Djulbegovic
authors.forename: Ambuj
authors.initials: A
authors.lastname: Kumar
authors.forename: Branko
authors.initials: B
authors.lastname: Miladinovic
authors.forename: Tea
authors.initials: T
authors.lastname: Reljic
authors.forename: Sanja
authors.initials: S
authors.lastname: Galeb
authors.forename: Asmita
authors.initials: A
authors.lastname: Mhaskar
authors.forename: Rahul
authors.initials: R
authors.lastname: Mhaskar
authors.forename: Iztok
authors.initials: I
authors.lastname: Hozo
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Tu
authors.forename: Heather A
authors.initials: HA
authors.lastname: Stanton
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Booth
authors.forename: Ralph M
authors.initials: RM
authors.lastname: Meyer
mesh_terms: D000047:Academies and Institutes; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D007221:Industry; D009369:Neoplasms / Q000628:therapy*; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
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