| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2005;129:1205
© 2005 The American Association for Thoracic Surgery
Letters to the Editor |
a On behalf of the Non–Small Cell Lung Cancer Collaborative Group, Meta-analysis Group, MRC Clinical Trials Unit, London, United Kingdom
b Service de Biostatistique et d’Epidemiologie, Institut Gustave-Roussy, Villejuif, France
To the Editor:
In the September 2004 issue of the Journal, Sedrakyan and associates1 reported a systematic review and meta-analysis of postoperative chemotherapy versus surgery alone in non–small cell lung cancer. This meta-analysis is based on abstracted data from 15 randomized controlled trials (RCTs). This included 7200 patients and builds on results of our individual patient data-based (IPD) meta-analysis,2 published in 1995.
The Non–Small Cell Lung Cancer Collaborative Group, which was responsible for the IPD meta-analysis published in 1995, welcomes the meta-analysis provided by Sedrakyan and associates,1 which added summary data from 7 trials and approximately 5000 patients to information from the 1995 meta-analysis. However, the interpretation of the results is limited by the absence of trial description and quality evaluation. Furthermore, the results of any systematic review performed with data extracted from publications of trials should be viewed with a degree of caution.3
IPD meta-analyses, which involve the central collection, validation, and analysis of the original trial data, are the gold standard of systematic review and have many advantages over literature-based approaches. They allow the reviewer to check the data, ensure the randomization process was adequate, investigate heterogeneity, and report longer follow-up, and can limit many biases.4 They also permit subgroup analysis of patient level characteristics such as age or tumor stage. Of course, it is also well documented that this type of review takes longer to carry out.
The 1995 meta-analysis included more than 9000 patients from 52 RCTs and assessed the effect of chemotherapy in 4 different settings.
An updated and extended IPD meta-analysis is currently under way, and data collection is ongoing. New agents and timings have been investigated in all settings. The update consists of adding trials published since the 1995 analyses and additional follow-up data from trials already included, and investigating additional outcomes in certain settings. Seven different therapeutic questions will be addressed, and the total number of patients randomized has increased to approximately 23,000 patients. The corresponding protocols are available at the following websites: http://www.ctu.mrc.ac.uk/download.asp or http://www.igr.fr/php/index.php?ids_;path=2.51.70.127.567.
In a setting equivalent to that described by Sedrakyan and associates,1 we identified 22 new RCTs with more than 8000 new patients, bringing the total number of trials to 38. If we can include these patients, it would bring the total number of patients in this comparison alone to more than 10,500 patients or 23% more patients than are included in the review by Sedrakyan and associates.1
Although the meta-analyses by Sedrakyan and associates1 and a recent similar review by Hotta and associates5 are a valuable resource in the absence of other evidence, the results should be considered with caution until they can be compared with the updated IPD meta-analysis. We anticipate that the results of our IPD meta-analyses will be available in 2006.
References
This article has been cited by other articles:
|
|
 |
|
  NSCLC Meta-Analyses Collaborative Group Chemotherapy in Addition to Supportive Care Improves Survival in Advanced Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 16 Randomized Controlled Trials J. Clin. Oncol., October 1, 2008; 26(28): 4617 - 4625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Pignon, H. Tribodet, G. V. Scagliotti, J.-Y. Douillard, F. A. Shepherd, R. J. Stephens, A. Dunant, V. Torri, R. Rosell, L. Seymour, et al. Lung Adjuvant Cisplatin Evaluation: A Pooled Analysis by the LACE Collaborative Group J. Clin. Oncol., July 20, 2008; 26(21): 3552 - 3559. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
