Cancer: Hospitalization Discrepancy

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Chemotherapy hospitalization rates differ between real world and clinical trial settings.
Posted On: November 23, 2015
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A common chemotherapy side effect is loss of red blood cells, which can lead to severe fatigue, dizziness and irregular heartbeat.

Before chemotherapy drugs can be used in real world settings, they must undergo testing in clinical trials. These trials provide physicians with important knowledge about potential side effects that range from mild to severe, including those that require hospitalization.

Because physicians use hospitalization rates in clinical trials to help decide which chemotherapy drug to prescribe, it is important to know whether the rates seen during clinical trials reflect those in the real world; however, no explicit comparisons have ever been performed.

A new study by Drs. Rebecca Prince (Clinical Research Fellow, PM Cancer Centre) and Monika Krzyzanowska (Medical Oncologist, PM Cancer Centre) aimed to identify the frequency of chemotherapy-related hospitalization and the factors that led to it. By performing a comprehensive review of the medical literature, they found this data was rarely reported in clinical trials. Of the studies that did report hospitalization rates, the researchers found that people receiving chemotherapy for lung cancer were almost eight times more likely to be hospitalized than those receiving similar treatments in clinical trials. The factors leading to this increase, however, could not be determined.

“More rigorous reporting of hospitalization due to chemotherapy-related side effects in clinical trials would enable the creation of standardized risk measurements for chemotherapy drugs,” explains Dr. Krzyzanowska. “As frequent hospitalization reduces the quality of life for patients and incurs costs to the health care system, knowledge of these risks would help patients and doctors make decisions about the most appropriate treatment options and identify opportunities to improve care.”

This work was supported by The Princess Margaret Cancer Foundation.

Hospitalizations during systemic therapy for metastatic lung cancer: a systematic review of real world vs clinical trial outcomes. Prince RM, Atenafu EG, Krzyzanowska MK. JAMA Oncology. 2015 Sep 17. [Pubmed abstract]