The following article features coverage from the European Society for Medical Oncology (ESMO) Congress 2019. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

A study suggests that complementary medicine is commonly used by patients with cancer enrolled in phase 3 clinical trials, and these patients tend to be younger and have better ECOG performance status. Investigators from Canada reported at ESMO Congress 2019 in Barcelona, Spain, that complementary medicine products are concurrently used with conventional medicine, including natural products and homeopathy by up to 20% of patients.

Until now, the use of complementary medicine had not been well studied in patients with cancer participating in phase 3 trials. Researchers examined patient characteristics and outcomes among complementary medicine users enrolled in phase 3 trials conducted by the Canadian Cancer Trials Group (CCTG). They mined data from 6 trials that included patients with metastatic breast cancer, colorectal cancer (CRC), or non-small cell lung cancer (NSCLC).

Two of the investigators independently reviewed medications and any discrepancies were reviewed by a third investigator. The study included 3446 patients (17.7% with breast cancer, 44.4% with CRC, and 37.8% with NSCLC). The study demonstrated that 24,908 medications were being taken and 651 medications (2.6%) were considered complementary medicine products.

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The researchers found that 20.4% of patients were using complementary medicine, and its use in patients with lung cancer was associated with ECOG performance status of –1 vs +2 and weight loss of less than 5%. Among the patients with lung cancer, complementary medicine was also associated with nonsmokers and Eastern Asian ethnicity.

Patients who were more likely to use complementary medicine had CRC and were aged 65 and younger. Patients with fewer sites of metastases and normal hemoglobin were also more likely to use complementary medicine. Among patients with breast cancer, complementary medicine use was more common in patients younger than 50.

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Complementary medicine use was associated with worse quality of life indices. However, time to deterioration and incidence of adverse effects were not associated with its use. “[Hazard ratio] for [overall survival] in the lung cancer trials favored [complementary medicine] users; however, this should be interpreted with caution given the retrospective/post-hoc nature of this study and the more favorable baseline characteristics,” the researchers noted.


Well JC, Sidhu S, Ding K, et al. Complementary medicine (CM) use in phase III clinical trials (P3T) conducted by the Canadian Cancer Trials Group (CCTG). Presented at: ESMO Congress 2019; September 27-October 1, 2019; Barcelona, Spain. Abstract 1758PD.