Trials, Collaboration Might Help Reduce Survival Disparities Between Community, Academic Cancer Centers

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Better collaboration between community and academic cancer centers could benefit patients.
Better collaboration between community and academic cancer centers could benefit patients.

Among patients with metastatic non-small cell lung cancer (NSCLC), 2-year survival rates were found to be better for those who were treated at academic cancer centers compared with community-based hospitals — and survival improvements over time were more marked at academic centers — researchers from Duke University's Duke Cancer Institute in Durham, North Carolina, reported in the Journal of Thoracic Oncology.1

Reducing the survival disparity between academic and community settings might require accelerated introduction of newer treatment options into the community setting, suggested lead study author Sendhilnathan Ramalingam, MD, and colleagues at Duke University.

And, the survival disparity appears to have worsened over time. Based on retrospective data from the National Cancer Database (NCDB) on 193,279 patients treated between 1998 and 2010, the study found that 2-year survival rates were 11.5% for patients at academic centers, 9.2% for patients who were treated at community-based centers in 1998, and in 2010, 17.4% compared with 13.1%, respectively (P < .001).1

“A number of factors could be responsible for this, including the specialized teams for each cancer disease site, multidisciplinary forums, patient selection, and access to clinical trials,” commented Suresh Ramalingam, MD, professor of hematology and medical oncology at the Emory University School of Medicine and Winship Cancer Institute in Atlanta, Georgia. Dr Suresh Ramalingam was not involved in the Duke study.

“Targeted therapies have made a major difference in improving outcomes for lung cancer,” he said. “Adoption of molecular testing, however, seems to lag in certain community centers. This could be partly responsible for the observations from the study. It is important that every patient with lung adenocarcinoma undergo thorough molecular testing to select the optimal treatment approach.”

“Given advances in treatment, if dissemination of new treatments is slower to community practices, then this could explain the differences in outcomes,” agreed Joseph Unger, PhD, MS, of the SWOG Statistical Center in the public health sciences division of the Fred Hutchinson Cancer Research Center in Seattle, Washington.

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