As patients develop toxic side-effects, cancer treatment is adapted over time
by either delaying or reducing the dosage of the next chemotherapy course.
In this talk Marginal Structural Models in combination with InverseProbability-of-Treatment Weighted estimators to assess the causal effects of
chemotherapy regimen modifications on survival outcome will be discussed.
The focus is on the use of actual treatment data and Received Dose Intensity
in contrast with the use of intended treatment regimen. The latter approach,
known as Intention to treat, is very common but also very far from the
everyday clinical practice. In this talk, I will discuss the confounding nature
of toxic side-effects data and shows the damaging effect of not including
toxicity in the analysis.
The method developed is applied to the osteosarcoma randomised clinical
trials BO03 and BO06 (EORTC 80861 and 80931).
4 Novembre 2022
Marta Fiocco
University of Leiden