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Crossover does not confound, it informs: 177lutetium-PSMA-617 as an example
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DOI：10.1038/s41571-026-01182-7.png)
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Abstract
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Crossover in trials should not be viewed as confounding, but as informative. Crossover reveals whether deferring therapy produces outcomes comparable to those from earlier use. Statistical crossover-adjustment methods carry unaccounted biases and limited clinical utility. Crossover should instead guide treatment-sequencing decisions, weighing toxicity and cost against any overall survival benefit from earlier intervention.
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