- Time to treatment initiation (TTI) appears not to affect OS in advanced pancreatic cancer.
Why this matters
- This is the first study of TTI and advanced pancreatic cancer outcomes to account for lead time bias and the waiting time paradox.
- Analysis of records from a prospectively maintained database (n=297).
- Funding: Else Kröner-Forschungskolleg: Cancer Immunotherapy.
- To account for lead time bias, the researchers only included patients who outlived the cutoff points for TTI.
- 66% of patients had a TTI >21 days, defined by the researchers as a treatment delay. The most common reasons were a referral to an external treatment center (25.9%) and an additional biopsy (20.8%).
- There was no significant difference in OS between TTI above or below the median (TTI ≤29 vs TTI >29 days; HR, 1.12; P=.362), at the 75th percentile of 43 days (HR, 1.03; P=.856), or at the 90th percentile of 60 days (HR, 1.04; P=.861).
- The researchers accounted for the waiting time paradox, which can lead to reporting of improved survival with greater TTI when more severe cases are treated sooner: they found no correlation between TTI with carbohydrate antigen 19-9 levels (P=.17), which are the marker of severity.
- Retrospective study.