The need for randomized trials in mesothelioma: let's walk the talk

Our plain-English summary of The need for randomized trials in mesothelioma: let's walk the talk, by T. Treasure, S. Senan (The Oncologist, 2011).

The study

• Authors: T. Treasure, S. Senan
• Journal: The Oncologist
• Published: 2011;16(3):261-3
• Type of article: Comment, Editorial
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Randomized trials are not impossible but present considerable challenges and should be used selectively, alongside other forms of evidence, to guide practice in the management of malignant pleural mesothelioma.

In plain English

This was an editorial that reported no new data and did not discuss asbestos exposure. The authors wrote it in response to a review by Price on radiotherapy for malignant pleural mesothelioma, which suggested that more randomized controlled trials (RCTs) were needed. The authors argued that many features of an RCT besides random allocation could be used in other studies. These include setting outcomes in advance and recording results for every patient who starts a planned treatment. They criticized reports that described only patients who completed every part of a treatment. They noted that published median survival figures for patient groups ranged from 7 to 13 months. Uncontrolled studies could therefore present the same result as a gain or a loss. The authors argued that only an RCT ensures a fair comparison. They also argued that preventive radiotherapy to port sites might not need an RCT. If patients did not see port site recurrence as a significant problem, radiotherapy could be held in reserve, and a well-planned observational study could find such information more easily. The authors concluded that studies should be planned to fit the question and randomized where necessary.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: editorial (opinion article commenting on a review in the same issue); no new data
• Who was studied: No patients were studied; the editorial discusses published research on treatment of malignant pleural mesothelioma
• Exposure: Not studied: the editorial concerns treatments (radiotherapy, surgery, combined therapy) for malignant pleural mesothelioma, not asbestos exposure
• Main results:
  • Context (not a finding of this article): Price's review suggested that more randomized trials of radiotherapy were needed
  • The authors argued that the rigor of an RCT, such as recording outcomes for all patients who enter a study, need not be limited to RCTs
  • The authors argued that reports limited to patients who completed treatment leave out what happened to the other patients
  • The authors argued that published median survival figures for groups of patients range from 7 to 13 months, so a 10-month median survival could be presented as a gain or a loss
  • The authors argued that only an RCT ensures a fair comparison
  • The authors argued that preventive port site radiotherapy may not need an RCT. If patients do not regard port site recurrence as a significant problem, radiotherapy could be held in reserve, and that information is more easily found in a well-planned observational study
• The authors' conclusion: The authors concluded that studies should be planned to suit the question being asked and should be randomized where necessary

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleural Mesothelioma.

Related studies

• Need for randomized clinical trials testing targeted therapies in malignant pleural mesothelioma — N. Sobhani, G. Roviello, et al. (2017)
• Surgery for malignant pleural mesothelioma: why we need controlled trials — T. Treasure, M. Dusmet, et al. (2014)
• Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials — N. Druesne-Pecollo, P. Latino-Martel, et al. (2010)
• Multicenter randomized controlled trial of the management of unresectable malignant mesothelioma proposed by the British Thoracic Society and the British Medical Research Council — D.J. Girling, M.F. Muers, et al. (2002)
• Estimating treatment effects from a randomized clinical trial in the presence of a secondary treatment — M. Zhang, Y. Wang (2012)
• Prophylactic irradiation of tracts in patients with malignant pleural mesothelioma: A systematic review and meta-analysis of randomized trials — C.C. Lee, Y.Y. Soon, et al. (2021)

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