Systematic review and meta-analysis of survival benefit associated with participation in clinical trials of anticancer drugs

Many cancer clinical investigators view clinical trials as offering better care for patients than routine clinical care. However, definitive evidence of the participation effect has yet to emerge. In a systematic review and meta-analysis of 39 studies (85 comparisons), cancer patient participation in trials was associated with greater survival benefit compared with routine care (HR 0.76). However, survival benefit was not significantly greater when only high-quality studies were pooled (HR 0.9) or when the sample was adjusted for possible publication bias (HR 0.94). The authors conclude that after accounting for biases and confounders, cancer clinical trial participation was not associated with longer survival.