In older patients with acute myeloid leukemia (AML), outcomes with intensive chemotherapy appeared to be similar whether patients were treated at community cancer centers, compared with academic cancer centers, in a recent study. The study’s findings were reported in the journal JCO Oncology Practice.
“The current study demonstrates that older patients with AML who choose to enroll in clinical trials in a community cancer center as opposed to an academic cancer center are likely to receive a high standard of medical care with comparable clinical outcomes,” the study investigators wrote in their report.
The study investigators used information from phase 3 trials of the Alliance for Clinical Trials in Oncology. Analyses involved patients 60 years of age or older who had newly diagnosed AML and were involved in the Cancer and Leukemia Group B (CALGB) 9720 trial or the CALGB 10201 trial.
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Data for outcomes of 1-month mortality, overall survival (OS), toxicities of grade 3 or higher, and allogeneic stem cell transplantation rates were evaluated based on whether patients were enrolled at centers that were regarded as community cancer centers, based on funding, or at academic cancer centers.
The study included 1170 patients overall. Among 665 patients from the CALGB 9720 trial, 12% were enrolled at community cancer centers, and among 505 patients in the CALGB 10201 trial, 25% were enrolled at community cancer centers.
Rates of 1-month mortality were 19.1% among patients treated at community cancer centers and 16.1% among those seen at academic cancer centers. The 1-year OS rates were 43.9% and 35.7%, respectively. In an analysis adjusted for covariates, for 1-month mortality, the odds ratio (OR) was estimated to be 1.40 (95% CI, 0.92-2.12; P =.11) for community versus academic cancer centers. In an adjusted analysis of OS, the OR was estimated to be 1.04 (95% CI, 0.88-1.22; P =.67).
Transplantation rates decreased with patient age across the study population, but rates were considered comparable for those seen at either community or academic cancer centers. Additionally, adverse events of grade 3 or higher were reported in 97% of patients at community cancer centers and in 93% of patients at academic cancer centers.
“This is the first study to demonstrate that the rates of grade ≥3 adverse events, 1-month mortality, or OS can be comparable regardless of whether patients enrolled in clinical trials of intensive chemotherapy at select community cancer centers versus academic cancer centers,” the study investigators stated in their report.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.
Reference
Bhatt VJ, Ulrich AM, Uy GL, et al. Outcomes of older adults with AML treated in community versus academic centers: an analysis of Alliance trials. JCO Oncol Pract. 2023;19(6):e877-e891. doi:10.1200/OP.22.00822
