Selection bias due to delayed comprehensive genomic profiling in Japan

Abstract

Patients with advanced cancer undergo comprehensive genomic profiling in Japan only after treatment options have been exhausted. Patients with a very poor prognosis were not able to undergo profiling tests, resulting in a selection bias called length bias, which makes accurate survival analysis impossible. The actual impact of length bias on the overall survival of patients who have undergone profiling tests is unclear, yet appropriate methods for adjusting for length bias have not been developed. To assess the length bias in overall survival, we established a simulation-based model for length bias adjustment. This study utilized clinicogenomic data of 8813 patients with advanced cancer who underwent profiling tests at hospitals throughout Japan between June 2019 and April 2022. Length bias was estimated by the conditional Kendall τ statistics and was significantly positive for 13 of the 15 cancer subtypes, suggesting a worse prognosis for patients who underwent profiling tests in early timing. The median overall survival time in colorectal, breast, and pancreatic cancer from the initial survival-prolonging chemotherapy with adjustment for length bias was 937

Factors predictive of second‐line chemotherapy in soft tissue sarcoma: An analysis of the National Genomic Profiling Database

“…Left truncation, a phenomenon in which survival information is agnostic prior to the start of follow‐up, causes a non‐negligible bias in survival analysis. Therefore, the association between oncogenic mutations and survival was assessed after correcting for left‐truncation bias 29 …”

“…Therefore, the association between oncogenic mutations and survival was assessed after correcting for left-truncation bias. 29 Survival information after the first SPT was available for 802 patients. The association between oncogenic mutations and survival was examined for 30 genes with a high frequency of oncogenic F I G U R E 1 Characteristics of 1761 sarcoma patients with 14 histological types.…”

“…In Japan, clinicogenomic data on more than 60,000 patients who have undergone cancer genome profiling are collected in a national central database, the Cancer Genome Information Center (C‐CAT) 28 . These big data include information about histology, genetic mutations, and treatment information and are widely used by hospitals, academic institutions, and industries for research and drug discovery purposes 29 . Owing to the unique insurance coverage system for STS treatment in Japan, the database contains much information about the utility and effectiveness of trabectedin and eribulin for non‐L‐sarcoma STS.…”

Construction and validation of a prognostic prediction model for gastric cancer using a series of genes related to lactate metabolism

“…Most of our data was downloaded from the public database, with the clinical information of some patients incomplete, and there is only a small number of cases from Sun Yat-sen University Cancer Center. At the same time, as a retrospective study, information bias is inevitable [ 55 ], so it is necessary to prove the clinical predictive value of the model through more convincing prospective studies in future clinical practice.…”

Travel Time and Distance and Participation in Precision Oncology Trials at the National Cancer Center Hospital

“…All patients were referred to the NCCH following discussion by regional molecular tumor boards (MTB) comprising medical oncologists, pediatric oncologists, pathologists, bioinformaticians, genome researchers, and genetic counselors . In addition to reports from the inspection companies, the MTBs used reports containing clinical annotation and information regarding genotype-matched clinical trials from the Center for Cancer Genomics and Advanced Therapeutics national database …”