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The British trial that asked, without enthusiasm or spin, what chemotherapy is actually worth in lung cancer, and found it worth nine weeks in advanced disease and nothing at all after surgery or radiotherapy.
The Big Lung Trial was designed to be ordinary: a large pragmatic test, in four separate primary-treatment settings, of the conclusion of the 1995 non-small-cell lung cancer meta-analysis. In the supportive care setting it randomised 725 people and found that chemotherapy improved survival with a hazard ratio of 0.77 (95 percent confidence interval 0.66 to 0.89, p = 0.0006), a median gain from 5.7 to 8.0 months, or nine weeks. There were 19 treatment-related deaths (5 percent), no significant differences on the pre-defined quality-of-life endpoints, and the regimens were cost-effective because the extra cost was offset by longer survival.
In the surgical setting it randomised 381 people and found no overall survival benefit (hazard ratio 1.02, 0.77 to 1.35, p = 0.90). In the radical radiotherapy setting it randomised 288 and found none either (hazard ratio 1.07, 0.84 to 1.38), closing early for slow accrual. The trial also produced one of the most useful pieces of honesty in British trial history: of 688 newly diagnosed patients at two London centres, only 63 (9.2 percent) entered, and of the 253 who were potentially eligible, 186 (73.5 percent) refused.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.