How do U.S. medical oncologists learn and apply new clinical trials information from press releases in nonmedical media? A case study based on ECOG 4599.

摘要

BACKGROUND: Practicing oncologists are expected to easily assimilate large amounts of rapidly evolving clinical data. We hypothesized that U.S. oncologists rapidly familiarize themselves with new, practice-relevant, phase III clinical trial data. We tested this hypothesis in relation to the release of phase III data from the Eastern Cooperative Oncology Group 4599 trial on the role of bevacizumab in advanced non-small cell lung cancer (NSCLC). METHODS: We queried approximately 310 medical oncologists concerning their awareness of the bevacizumab data within 1 and 3 weeks after the data release or immediately after the 2005 Annual Meeting of the American Society of Clinical Oncology (ASCO). RESULTS: Prior to the ASCO meeting, 57% and 56% of the oncologists in the two research meetings, respectively, indicated "awareness" of the data release. Less than 25% selected an accurate descriptor of the released information from a short list of plausible options. After the ASCO meeting, the figures were 88% and 34%. Over 50% said they plan to use bevacizumab in NSCLC treatment as soon as reimbursement is secure. Eighty-two percent said they plan to use it in second- or third-line treatment; 56% said they plan to use it during second-line chemotherapy despite progression during first-line use. A large majority intend to use bevacizumab in dosages, tumor types, drug combinations, and/or patients not specifically supported by phase III data. CONCLUSION: Release of clinically relevant phase III data through electronic and print media is a poor vehicle for informing U.S. medical oncologists. For a commercially available agent, this can have important implications for potential use in untested and potentially unsafe clinical settings. Effective educational strategies for dealing with the new paradigm of "instant" release of clinical data need to be developed.