title: Survival of Patients with Advanced Non-Small Cell Lung Cancer Enrolled in Clinical Trials.
abstract: BACKGROUND
  Up-to-date oncological therapy has been accomplished through the results of clinical trials (CTs). We analyzed the overall survival (OS) of patients with non-small cell lung cancer (NSCLC) and its relation to CT enrollment.
  
  
  METHODS
  The study included 1,042 patients with advanced NSCLC treated at the Instituto Nacional de Cancerología. All patients received treatment according to the national and international guidelines. Data were collected from medical records. Patients were subgrouped on the basis of their CT enrollment as follows: participants in any CT (ACT), exclusively intervention CTs (ICT) or exclusively pharmaceutical-sponsored CTs (PCT).
  
  
  RESULTS
  The CT enrollment effect was assessed through a multivariate Cox proportional hazards model. Thirty percent of the patients were in ACT, 28.3% in ICT and 13.7% in PCT. Female gender (p = 0.001), adenocarcinoma histology (p = 0.018), positive EGFR mutation (p = 0.006), and better ECOG performance status (<2) (p ≤ 0.0001) were more frequent in patients enrolled in CT; further, tobacco smoking (p ≤ 0.0001) and KRAS mutation (p = 0.001) were more frequent in patients who were not enrolled in a CT.
  
  
  CONCLUSIONS
  Enrollment in ACT was associated with a better OS (hazard ratio: 0.47-0.74). NSCLC patients enrolled in a CT have an improved survival in an independent manner to other prognostic factors.
authors.affiliation: Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Arrieta
authors.forename: Amir
authors.initials: A
authors.lastname: Carmona
authors.forename: Laura Alejandra
authors.initials: LA
authors.lastname: Ramírez-Tirado
authors.forename: Diana
authors.initials: D
authors.lastname: Flores-Estrada
authors.forename: Eleazar Omar
authors.initials: EO
authors.lastname: Macedo-Pérez
authors.forename: Jorge Negueb
authors.initials: JN
authors.lastname: Martínez-Hernández
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Corona-Cruz
authors.forename: Andrés F
authors.initials: AF
authors.lastname: Cardona
authors.forename: Jaime
authors.initials: J
authors.lastname: de la Garza
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000401:mortality* / Q000628:therapy; D002986:Clinical Trials as Topic; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D012737:Sex Factors; D012907:Smoking; D015996:Survival Rate
chemical_list: C117307:KRAS protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras)