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Lung cancer pill cuts risk of death by half

theguardian.com

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Re: Lung cancer pill cuts risk of death by half

#2
Can someone explain the numbers to me?

"After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo."

So 88% instead of 78% without the pill were still alive five years on. I assume that is the maximum range they could test. How was the 51% then calculated?

Edit: thank you all for the explanation. That makes a lot of sense!

Re: Lung cancer pill cuts risk of death by half

#3
post #2

Can someone explain the numbers to me? "After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo." So 88% instead of 78% without the pill were still alive five years on. I assume that is the m…

The article makes the assumption that those that took the placebo represent the typical post removal patient (an assumption).

So, for 100 untreeated patients 22 would die. Now for these 100 placebo patients, if they took the pill, they would die 12 (another assumption that the two populations are the same).

The reduction is (22-12) / 22 = 10/22 is the risk of death if untreated.

The complementary percentage is

12/22 approx 51%.

However this does not come with confidence intervals.

Re: Lung cancer pill cuts risk of death by half

#4
post #2

Can someone explain the numbers to me? "After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo." So 88% instead of 78% without the pill were still alive five years on. I assume that is the m…

If 22% of patients in the placebo group died, and 12% in the test group, then that's a reduction of 1 - (12/22) = 45% in the risk of death over that time interval.

The true value could easily be 51% if the percentages reported in the Guardian were rounded.

Re: Lung cancer pill cuts risk of death by half

#5
post #2

Can someone explain the numbers to me? "After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo." So 88% instead of 78% without the pill were still alive five years on. I assume that is the m…

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Re: Lung cancer pill cuts risk of death by half

#6
post #2

Can someone explain the numbers to me? "After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo." So 88% instead of 78% without the pill were still alive five years on. I assume that is the m…

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Re: Lung cancer pill cuts risk of death by half

#8
This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases.

This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond.

So do that math, and you end up seeing that treating one of the most common mutations in one of the most common cancers with what is considered very high efficacy still only helps with about 1.4% of all cancers. This is actually an enormous number for this kind of treatment, and there is a long tail of rare cancers that are going to be much harder to find targeted therapies for.

That all said, this currently appears to be an enormous success story, and the kind of treatment options that have been enabled by genomic sequencing of cancers, followed by many years of drug development and clinical trials. It's fantasically exciting to see us continue to chip away at the problem but by bit and grant people longer lives as a result!

Re: Lung cancer pill cuts risk of death by half

#9
post #2

Can someone explain the numbers to me? "After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo." So 88% instead of 78% without the pill were still alive five years on. I assume that is the m…

22% of those who took the placebo died versus 12% with the medication. Seems it’d be a 45% improvement with those numbers.

Re: Lung cancer pill cuts risk of death by half

#10
post #2

Can someone explain the numbers to me? "After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo." So 88% instead of 78% without the pill were still alive five years on. I assume that is the m…

If you think about the numbers as 12% died vs 22% died, then the 51% intuitively makes more sense, although I don’t know if this is the correct explanation. My guess is that 12 and 22 are rounded numbers.
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