Hori Akiko, Shibata Taro, Kami Masahiro, Kusumi Eiji, Narimatsu Hiroto, Kishi Yukiko, Murashige Naoko, Mori Kazuhiko
Office of New Drug I, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan.
Cancer. 2007 Jun 15;109(12):2541-6. doi: 10.1002/cncr.22721.
Underrepresentation of older patients in cancer clinical trials has been reported previously.
To evaluate disparities in age between actual cancer patients and those enrolled in clinical trials, the authors examined all the review reports of the Pharmaceuticals and Medical Devices Agency, Tokyo, Japan, and summaries of data submitted by applicants for the approval of new cancer drugs and that of a partial change in approved cancer drugs.
Information regarding 68 clinical trials was available on the Internet. The median age of trial participants ranged from 33 years to 73 years and was older than 65 years in 13 trials, whereas the estimated median age of patients with all cancers was 69 years, and 64% of these individuals were age > or =65 years. The median age of trial participants was found to be lower than that of the patient population in 60 trials. The median difference in age between the 2 groups was 7 years (range, -16 to +33). With regard to molecular-targeting agents (16 trials) and hormonal agents (10 trials), trial participants were younger than the patient population in 25 of the 26 trials, with a median difference of 6 years (range, -9.5 to +20). The difference was larger for molecular-targeting agents (median, 9.5 years; range, birth-20 years) compared with hormonal agents (median, 2 years; range, -9.5 to +15).
The results of the current study show that participants in cancer clinical trials are younger than the actual Japanese cancer patient population.
此前已有报道称老年患者在癌症临床试验中的代表性不足。
为评估实际癌症患者与参加临床试验患者之间的年龄差异,作者查阅了日本东京药品和医疗器械管理局的所有审评报告,以及新药申请和已批准癌症药物部分变更申请提交的数据摘要。
互联网上可获取68项临床试验的信息。试验参与者的年龄中位数在33岁至73岁之间,13项试验中年龄大于65岁,而所有癌症患者的估计年龄中位数为69岁,其中64%的患者年龄≥65岁。在60项试验中,发现试验参与者的年龄中位数低于患者群体。两组年龄的中位数差异为7岁(范围为-16至+33)。对于分子靶向药物(16项试验)和激素类药物(10项试验),26项试验中有25项试验的参与者比患者群体年轻,中位数差异为6岁(范围为-9.5至+20)。与激素类药物(中位数为2岁;范围为-9.5至+15)相比,分子靶向药物的差异更大(中位数为9.5岁;范围为出生至20岁)。
当前研究结果表明,癌症临床试验参与者比实际日本癌症患者群体年轻。