Research Highlights
Pooled study data accelerate clinical research and insights
Our network maintains a high level of activity, consistently producing research that influences clinical practice. With six decades of experience, we have developed hundreds of clinical trials both collaboratively and independently.
Projects initiated within our organization adhere to standardized protocols, utilizing uniform Standard Operating Procedures (SOPs) and rigorous quality controls—such as comprehensive data completion and consistent semantic standards. This framework enables clinicians, following appropriate ethical approvals, to pool data across different studies and address transversal research questions after trial completion. Such data reuse is vital for advancing human research efficiently. It is essential, however, that pooled trials share comparable clinical contexts. A further challenge arises from the rapid evolution of clinical practice, as standards of care may change swiftly, potentially rendering studies outdated and unsuitable for comparison or aggregation. Major project groups within our network, like lung and breast for example, benefit from the ability to conduct multiple trials within condensed timeframes, thereby facilitating robust data pooling. Only a highly organized, nation-wide infrastructure like the Swiss Cancer Institute can effectively implement this approach, allowing clinical research to progress without additional patient recruitment or data collection.
This year, two publications resulted from the utilization of pooled clinical trial data.
Publication 01
The first manuscript presents an integrated analysis of sex-related differences in survival outcomes and safety among patients with resectable stage III non-small-cell lung cancer (NSCLC), drawing on the five Swiss Group for Clinical Cancer Research (SAKK) trials SAKK 16/96, 16/00, 16/01, 16/08 and 16/14. The study evaluated 499 patients and found that females experienced significantly longer event-free survival (EFS) and overall survival (OS) than males, primarily attributable to lower non-cancer-related mortality among women. The incidence of treatment-related adverse events and discontinuation rates was similar between sexes; nevertheless, these results indicate a potential survival advantage for female patients. The authors advise caution due to the retrospective nature and limited sample size of the analysis, emphasizing the need for prospective studies to validate these findings and examine the underlying mechanisms of sex-based disparities.
Publication 02
The second publication examines outcomes in patients with resectable stage III-N2 NSCLC who did not undergo definitive surgery following neoadjuvant or perioperative therapy—including immune checkpoint inhibitors (ICIs). Among 499 participants from five SAKK trials, approximately 20% did not proceed to surgery, with cancellation rates appearing independent of ICI administration. Reasons for the omission of surgery included disease progression, unresectability, medical contraindications, and unknown factors. Patients who underwent definitive surgical intervention demonstrated significantly higher three-year overall survival compared with those who did not. Notably, the prognosis for non-surgical patients has improved in the era of ICIs, suggesting that evolving therapeutic strategies may provide enhanced benefits for this subgroup.
These two projects showcase two strengths of the Swiss Cancer Institute: one is the strong track history with trials that build upon each other and keep up with the current developments in the field. The other is the re-use of data to answer newly emerging questions or questions that would not have been possible to answer with the data of a single trial.