Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Objective: The objective of this EBM review is to determine whether or not crizotinib works better in reducing the chest pain of ALK-positive non-small cell lung cancer (NSCLC) patients compared with chemotherapy.
Study Design: This paper evaluates three randomized controlled trials (RCTs), which were all published in peer-reviewed journals in English after 2013.
Data Sources: Three RCTs comparing the efficacy of crizotinib in reducing the chest pain in ALKpositive non-small cell lung cancer patients with chemotherapy including pemetrexed and docetaxel. Articles were selected via PubMed based on the outcomes of the studies mattered to patients (POEM).
Outcomes Measured: The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 13-item lung cancer module (EORTC QLQ-LC13) was completed by patients, the scores were used to measure lung cancer specific symptoms including chest pain.
Results: All the three RCTs articles (Shaw 2013, Solomon, 2014, Blackhall 2014) showed that crizotinib is more effective in decreasing the chest pain in ALK-positive NSCLC patients than chemotherapy (P<0.001 [pemetrexed or docetaxel], P<0.001 [pemetrexed], P<0.05 [pemetrexed] and P<0.001 [docetaxel]). All these studies suggest that crizotinib is superior to chemotherapy (pemetrexed or docetaxel) in reducing chest pain for ALK-positive NSCLC patients.
Conclusions: The data analysis of these studies indicates crizotinib works better in reducing the chest pain in ALK-positive NSCLC patients compared with chemotherapy including pemetrexed and docetaxel. The studies are limited to ALK-positive NSCLC patients. The treatments in the studies are not double-blinded, chest pain could be caused by other factors such as anxiety, which were not evaluated in this study.
Sun, Qian, "Does crizotinib work better in reducing the chest pain of ALKpositive non-small cell lung cancer patients compared with chemotherapy?" (2020). PCOM Physician Assistant Studies Student Scholarship. 506.