A group of experts from AIIMS Delhi, McMaster University in Canada and the International Agency for Research on Cancer (IARC) in France has stressed the need to record smoking status in cancer clinical trials, warning that continued tobacco use can reduce treatment efficacy and patient survival. In a commentary published in the Lancet Oncology this month, the seven authors, including Dr Abhishek Shankar from AIIMS Delhi, said knowledge of smoking status during therapy could influence clinical decisions.
They argued that addressing barriers to tobacco-use assessment and embedding smoking cessation initiatives into oncology research protocols will improve trial outcomes, enhance therapeutic efficacy and save lives.
The researchers cited the 2014 US Surgeon General’s report ‘The Health Consequences of Smoking — 50 Years of Progress’, which for the first time concluded there was a causal link between cigarette smoking and adverse cancer-related outcomes, including higher all-cause and cancer-specific mortality.
This report underscores the need to systematically capture smoking status in clinical trials, to refine estimates of efficacy of novel therapies and to better understand the impact of continued tobacco use across treatment modalities and disease sites.
Since 2014, research has increasingly shown that continued tobacco use negatively impacts patients receiving surgery, radiotherapy or systemic therapies.
The mechanisms by which tobacco smoke worsens outcomes remain unclear but may include tumour hypoxia, altered drug metabolism, stimulation of signalling pathways by nicotine and changes to the immune system, including reduced natural killer cells, the authors noted. Source: PTI