Biostatistic Unit, Montpellier Cancer Institute, Montpellier; Data Center for Cancer Clinical Trials, CTD-INCa, Montpellier, France.
Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Edinburgh, UK.
Ann Oncol. 2015 May;26(5):873-879. doi: 10.1093/annonc/mdv106. Epub 2015 Feb 27.
Using surrogate end points for overall survival, such as disease-free survival, is increasingly common in randomized controlled trials. However, the definitions of several of these time-to-event (TTE) end points are imprecisely which limits interpretation and cross-trial comparisons. The estimation of treatment effects may be directly affected by the definitions of end points. The DATECAN initiative (Definition for the Assessment of Time-to-event Endpoints in CANcer trials) aims to provide recommendations for definitions of TTE end points. We report guidelines for randomized cancer clinical trials (RCTs) in breast cancer.
A literature review was carried out to identify TTE end points (primary or secondary) reported in publications of randomized trials or guidelines. An international multidisciplinary panel of experts proposed recommendations for the definitions of these end points based on a validated consensus method that formalize the degree of agreement among experts.
Recommended guidelines for the definitions of TTE end points commonly used in RCTs for breast cancer are provided for non-metastatic and metastatic settings.
The use of standardized definitions should facilitate comparisons of trial results and improve the quality of trial design and reporting. These guidelines could be of particular interest to those involved in the design, conducting, reporting, or assessment of RCT.
在随机对照试验中,使用替代终点(如无病生存期)来评估总生存期的情况越来越常见。然而,这些时间事件(TTE)终点的几个定义并不精确,这限制了对这些终点的解释和跨试验比较。治疗效果的估计可能会直接受到终点定义的影响。DATECAN 倡议(癌症试验中时间事件终点评估的定义)旨在为 TTE 终点的定义提供建议。我们报告了乳腺癌随机癌症临床试验(RCT)的指南。
对已发表的随机试验或指南中报告的 TTE 终点(主要或次要)进行文献回顾。一个由国际多学科专家组成的小组根据一种经过验证的共识方法提出了这些终点定义的建议,该方法正式确定了专家之间的一致性程度。
为非转移性和转移性乳腺癌 RCT 提供了 TTE 终点常用定义的推荐指南。
使用标准化的定义应有助于比较试验结果,并提高试验设计和报告的质量。这些指南对于参与 RCT 的设计、实施、报告或评估的人员可能特别感兴趣。