This is an interesting exploratory study examining the incidence of (and reasons behind) re-challenging patients with trabectedin after experiencing drug related CK elevation. My only concern with the proposal is with whether the investigators know what the 4 RCT protocols required investigators to do in the event of a CK elevation during the trial. Did the investigators have any leeway to decide whether or not to re-challenge patient with trabectedin? Or were investigators told to discontinue treatment for the remainder of the trial?
This study will only be able to characterize incidence in the trials, not in the real world, and the trials may have had explicit protocols instructing investigators what to do in the event of a CK elevation.