A Study of Patients with Metastatic Renal Cell Carcinoma (RCC)

question 887

Multiple Choice

A study of patients with metastatic renal cell carcinoma (RCC) compared the effectiveness of standard chemotherapy to a novel tyrosine kinase inhibitor (TKI) with activity against vascular endothelial growth factor in progression-free survival (primary end point) as first-line treatment.  Tumor response was significant in both groups at final follow-up (p < 0.05) .  The Kaplan-Meier survival curve for overall survival is shown below. Treatment-related adverse events such as diarrhea, nausea, vomiting, hypertension, hand-foot syndrome, asthenia, leukopenia, neutropenia, thrombocytopenia, lymphopenia, and increased lipase and uric acid occurred more frequently in the TKI group than in the standard chemotherapy group (p < 0.05) .  Based on the findings of this study, which of the following conclusions is justified?

• A)Either treatment can be recommended because there is no significant difference in outcomes between the 2 groups
• B)Neither treatment should be recommended because there is no significant difference in outcomes between groups
• C)Standard chemotherapy should be recommended because it is associated with lower rates of treatment-related adverse events
• D)TKI therapy should be recommended because its use resulted in longer overall survival estimates

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Definitions:

Population Proportion

The fraction of members in a group that possess a particular characteristic, often expressed as a percentage of the total population.

Confidence Interval

An assortment of values, from sampled evidence, which possibly contains the value of an unknown parameter of the population.

Estimator

An estimator refers to a statistic used to estimate the value of a population parameter based on sample data.

Significance Level

The probability of rejecting the null hypothesis in a statistical test when it is actually true, typically denoted by alpha (α).