Retrospective study of health care contact day and outcomes in clinical trials versus routine care among patients with non-small cell lung cancer

Although patients enrolled in clinical trials have superior survival outcomes compared with those in routine practice, it is unknown whether such differences extend to contact days, a measure of time toxicity. A population-based, retrospective, matched cohort study assessed adult patients with advanced stage non-small cell lung cancer receiving specific, systemic, palliative-intent, cancer-directed drug(s) as part of a trial matched 1:1 with patients who received the same drug(s) after approval in routine practice in the same line of treatment. In this study of 250 patients, those who received treatment in clincial trials experienced a lower proportion of contact days during active treatment, accounted for by greater hospitalization rates in routine practice. The authors conclude that the greater proportion of contact days (higher time toxicity) during active treatment for patients in routine practice has ramifications for setting expectations for these patients, while easing theoretical concerns regarding the additional time toxicity associated with clinical trial participation.