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Meta-analyses for the improved treatment of cancer


The major aims of the European Organisation for Research and Treatment of Cancer (EORTC), which involves the participation of more than 300 European institutions, include the co-ordination of research in Europe on cancer treatment, the linking of clinical practice to ongoing basic research, and the dissemination of state of the art knowledge in oncology among hospitals and clinicians in Europe.

As numerous publications have shown, it is well known that many clinical trials include too few patients in order to be able to reliably detect small to moderate (but medically important) treatment differences. Given that many small, inconclusive trials exist, the best way to combine together and objectively summarise the results from trials that ask similar questions is through the technique of meta-analyses (overviews). Meta-analysis is the process of using formal statistical methods to combine the quantitative results of separate but similar studies in order to increase the statistical precision of the estimated treatment effects. Meta-analyses provide clinicians, patients and policy markers with reliable, objective evidence on the effects of health care in order for professionals and providers, service users and purchasers, and researchers and funders to be able to set priorities and establish resources for both medical research and patient treatment. In this way truly informed decisions can be made concerning the potential impact of new therapies in clinical practice.

With the support from the European Commission through BIOMED 1, the EORTC Data Centre established a Meta-Analysis Co-ordination Unit (EORTC MAU) in May 1994. This has provided the EORTC with the scientific means and expertise required to identify, process and analyse the individual patient data from trials to be included in meta-analyses which are conducted by the unit. It also co-ordinates and provides data for patients entered in EORTC trials to be included in meta-analysis projects undertaken by other groups. Creation of this Unit has provided the means to successfully increase the contacts and co-ordination of meta-analysis activities with other centres such as the Medical Research Council (MRC) Clinical Trials Services Unit in 0xford, Great Britain, and the MRC Cancer Trials Office in Cambridge, Great Britain with whom joint projects exist.

The success of the work already accomplished by the EORTC MAU forms the basis of this grant submission which builds upon and extends the work of the MAU which was funded through BIOMED 1 for the period from May 1994 to April 1996. In particular, a continuation of meta-analysis projects in acute mylogenous leukaemia, superficial bladder cancer and early breast cancer is sought (in order to allow for their up-dating, an essential requirement to ensure conclusive results) along with the creation of new projects in malignant melanoma, soft tissue sarcoma, locally advanced head and neck cancer, and locally advanced cervical cancer. These are other types of cancer for which many trials have been carried out, but with inconclusive results and for which meta-analyses are therefore important.

Through these meta-analyses and the dissemination of their results as widely and rapidly as possible with the European Community, it will be possible to further improve the treatment and management of cancer in Europe. In this way as many patients as possible will profit from state of the art treatment, even those treated outside of research oriented institutes.

A reinforced concerted action is being requested in order to permit the training of scientists in the conduct of meta-analyses, thus allowing the further dissemination of this technology within the Member States.

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European Organization for Research and Treatment of Cancer
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