title: Sex Differences in Hazard Ratio During Drug Treatment of Non-small-cell Lung Cancer in Major Clinical Trials: A Focused Data Review and Meta-analysis.
abstract: Understanding how sex impacts the efficacy of anticancer agents is a crucial step toward personalized and precision medicine. This review and meta-analysis evaluated sex differences in hazard ratios (HRs) of progression-free survival and overall survival in representative Phase III clinical trials of non-small-cell lung cancer (NSCLC).
  
  
  
  Data were extracted from 24 large-scale clinical trials that included 12,000 male and 7000 female patients. The data were examined for HR differences between subgroups by sex, smoking status, and age, and for potential sex-smoking status, sex-age, and sex-drug interactions, during cancer treatment.
  
  
  
  Summarized information revealed variations in the influences of sex, smoking status, and age on the efficacy of drugs used for the treatment of NSCLC. The male and female subgroups had different HR values. Smoking status, age, and the percentage of female patients in a treatment group had no influence on the sex HR. The sex difference was supported by a set of data collected from all journals.
  
  
  
  The findings from this meta-analysis are important for assessing potential toxicity during drug treatment in both sexes. The outcomes measures of a drug in clinical application should be specified by subpopulation, such as males versus females, as a first step in personalized medicine.
authors.affiliation: Department of Basic Medicine (Basic Medical Research), Inner Mongolia Medical University, Inner Mongolia, People׳s Republic of China; Department of Orthopedic Surgery and BME-Campbell Clinic, The University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Lishi
authors.initials: L
authors.lastname: Wang
authors.affiliation: National Center for Endemic Disease Control, Harbin Medical University, Harbin, People׳s Republic of China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Basic Medicine (Basic Medical Research), Inner Mongolia Medical University, Inner Mongolia, People׳s Republic of China.
authors.forename: Mingji
authors.initials: M
authors.lastname: Ren
authors.affiliation: Department of Basic Medicine (Basic Medical Research), Inner Mongolia Medical University, Inner Mongolia, People׳s Republic of China.
authors.forename: Amei
authors.initials: A
authors.lastname: Chen
authors.affiliation: Department of Orthopedic Surgery and BME-Campbell Clinic, The University of Tennessee Health Science Center, Memphis, Tennessee; Center of Integrative Research, The First Hospital of Qiqihaer City, Qiqihaer, People׳s Republic of China.
authors.forename: Jinglin
authors.initials: J
authors.lastname: Cui
authors.affiliation: National Center for Endemic Disease Control, Harbin Medical University, Harbin, People׳s Republic of China.
authors.forename: DiaJun
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Orthopedic Surgery and BME-Campbell Clinic, The University of Tennessee Health Science Center, Memphis, Tennessee; Research Service, Veterans Affairs Medical Center, Memphis, Tennessee. Electronic address: wgu@utusc.edu.
authors.forename: Weikuan
authors.initials: W
authors.lastname: Gu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D016016:Proportional Hazards Models; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents
keywords: age; cancer; drug; gender; lung; smoke