Monday, March 31, 2014

Age, Race, Sex, and Follicular Lymphoma

An article that will be published in the next issue of The American Journal of Hematology looks at "The Impact of Race, Age, and Sex in Follicular Lymphoma: A Comprehensive SEER Analysis Across Consecutive Treatment Eras." Basically, the authors looked back at the records of about 18,000 patients with Follicular Lymphoma from 1992 to 2009 to see how they did. (A SEER analysis is a look at the Surveillance, Epidemiology, and End Results database from the National Cancer Institute. That's important to know -- the researchers looked at electronic records, not actual patients.)

One of the things they really wanted to look at was the differences between two eras of treatment: 1992 to 2000, and 2001 to 2009. The separation, of course, is due to Rituxan; era 2 in this study is often called "The Rituxan Era," though it sometimes is given an earlier starting date. The 2001 date here is probably a reference to when Rituxan was used widely.

So, this is a study of statistics from the past. It doesn't say much of anything about any of us in the present. That's important to know, too.

Researchers found that, basically, things got a whole lot better once Rituxan came to town. We already knew that, of course, but this is the first time we get a sense of who seems to have benefited, in a general way, and how.

I'm not going to break down how particular ages, races, sexes, and classes did. I think there's some value for researchers in knowing those things. Maybe knowing that (and I'm making this up) working-class white men in their forties with blue eyes did worse in the Rituxan era than they did before (and, again I just made up that statistic) would lead some researchers to start asking why Rituxan wasn't working for them, and figure out if age or race or something else plays a role in Rituxan's effectiveness. I don't see how else something like this -- a study of the past -- can help patients in the present. At worst, it can just get some of us thinking too much about things that don't really matter.

Here's the one statistic that does matter, as far as I am concerned: "Overall survival (OS) was superior in Era-2 versus Era-1 for all patients (5-year: 76.7% versus 67.4%, respectively)."

In other words, Rituxan has made our lives better, and our survival last longer.

That's not just a pitch for Rituxan (though goodness knows I'm happy to sing its praises). Era 2 in this study goes until 2009. We're in era 3 now. We're in the post-Rituxan era. The era of humanized monoclonal antibodies. The era of prohibitors. The era of targeted therapies.

If Rituxan did that much for us, as a group, imagine what all of this other awesome stuff will do for us. A cure? Maybe. But even if it means a way of controlling Follicular Lymphoma, taming it,  making it truly a chronic disease, that would be something pretty awesome, too.

So look at those statistics from the past if you're curious. But remember that stats from the past have not much to do with you in the present. 

And even less to do with your future.

No comments: