Gondek Kathleen, Sagnier Pierre-Philippe, Gilchrist Kim, Woolley J Michael
Bayer Corporation, West Haven, CT 06516, USA.
J Clin Oncol. 2007 Nov 10;25(32):5087-93. doi: 10.1200/JCO.2007.11.3845.
Assessing patient-reported outcomes (PROs) in clinical trials is of interest to clinicians, patients, regulators, and industry. The use and impact of PROs is a growing area of methodologic research, particularly as they relate to tumor types, biomarkers, and various patient populations and cultures. Both the US Food and Drug Administration (FDA) and European Agency for the Evaluation of Medicinal Products in recent guidance have acknowledged the need to account for treatment-related impact on patient symptoms and/or health-related quality of life (HRQOL). Clinical research likely reflects the informative value of PROs. A search of www.clinicaltrials.gov, the FDA Web site, and product package inserts was conducted to assess the inclusion of symptom assessment and HRQOL within industry-sponsored clinical trials in cancer and approved cancer therapies and their respective product labels. Overall, there were 2,704 industry-sponsored oncology trials, of which 322 (12%) included a PRO measure. Of the 70 FDA new or revised labels, only six package inserts include PRO data. Symptoms were assessed uniformly across the phases of clinical trials, whereas HRQOL assessment increased in the later phases of clinical trials. Collecting PRO data can enhance our understanding of cancer burden and the impact of interventions on patients' lives.
在临床试验中评估患者报告的结局(PROs)受到临床医生、患者、监管机构和行业的关注。PROs的使用及其影响是方法学研究中一个不断发展的领域,特别是当它们与肿瘤类型、生物标志物以及各种患者群体和文化相关时。美国食品药品监督管理局(FDA)和欧洲药品评估局在近期的指南中都承认,有必要考虑治疗对患者症状和/或健康相关生活质量(HRQOL)的影响。临床研究可能反映了PROs的信息价值。我们检索了www.clinicaltrials.gov、FDA网站和产品包装说明书,以评估在行业资助的癌症临床试验以及获批的癌症治疗药物及其各自的产品标签中,症状评估和HRQOL的纳入情况。总体而言,有2704项行业资助的肿瘤学试验,其中322项(12%)纳入了PRO测量。在FDA的70个新的或修订的标签中,只有6份包装说明书包含PRO数据。症状在临床试验各阶段的评估是统一的,而HRQOL评估在临床试验后期有所增加。收集PRO数据可以增强我们对癌症负担以及干预措施对患者生活影响的理解。
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