Department of Clinical Pharmacy, College of Pharmacy, Chungnam National University, Daejeon, 305-764, South Korea.
Lung. 2013 Aug;191(4):313-9. doi: 10.1007/s00408-013-9479-z. Epub 2013 May 30.
The methodology of conducting clinical trials in lung cancer has been challenged by the particular characteristics of new targeted agents. Thus, the choice of correct outcome measures and selection of best study designs are essential. We assessed the trends in reporting of outcome measures in phase II and phase III trials conducted in advanced non-small-cell lung cancer (NSCLC) patients.
Data from September 2000 to September 2012 were extracted from the ClinicalTrials.gov database, and a descriptive-comparative analysis was performed to evaluate outcome-measures reporting for the two phases.
We identified 459 phase II and 128 phase III trials that met our inclusion criteria. The frequently reported primary outcomes in phase II trials were progression-free survival (PFS; 32%), response rate (RR; 21.4%), and safety and toxicity (adverse events [AEs]; 14.6%). In contrast, overall survival (OS; 60.9%) and PFS (26.6%) were frequently reported primary outcomes in phase III trials. AEs were reported as a secondary outcome measure in 50.1 and 64.8% of phase II and phase III trials, respectively. Improvement in quality of life was identified as a secondary outcome measure significantly more frequently in phase III than in phase II trials.
Our study identified recent trends in reports of outcome measures in advanced-stage NSCLC phase II and phase III trials. The outcomes of this study can be valuable for investigators with minimal or some experience in the field of oncology who are conducting clinical research.
新的靶向药物具有特殊的特征,这对肺癌临床试验的方法学提出了挑战。因此,选择正确的疗效评估指标和最佳的研究设计至关重要。我们评估了晚期非小细胞肺癌(NSCLC)患者进行的 II 期和 III 期临床试验中疗效评估指标报告的趋势。
从 ClinicalTrials.gov 数据库中提取 2000 年 9 月至 2012 年 9 月的数据,并进行描述性比较分析,以评估这两个阶段的疗效评估指标报告情况。
我们确定了 459 项 II 期和 128 项 III 期试验符合纳入标准。II 期试验中常报告的主要疗效终点为无进展生存期(PFS;32%)、缓解率(RR;21.4%)和安全性及毒性(不良事件 [AE];14.6%)。相比之下,III 期试验中常报告的主要疗效终点为总生存期(OS;60.9%)和 PFS(26.6%)。AE 分别作为 II 期和 III 期试验的次要疗效终点报告了 50.1%和 64.8%。与 II 期试验相比,III 期试验中明确将生活质量改善作为次要疗效终点的比例更高。
本研究确定了晚期 NSCLC II 期和 III 期临床试验中疗效评估指标报告的最新趋势。对于在肿瘤学领域经验较少或有一定经验的研究者开展临床研究,本研究的结果可能具有重要价值。