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肿瘤学临床试验中研究性活检的漏报。

Underreporting of Research Biopsies from Clinical Trials in Oncology.

机构信息

Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Houston Methodist Cancer Center, Houston Methodist Research Institute Methodist, Houston, Texas.

出版信息

Clin Cancer Res. 2017 Nov 1;23(21):6450-6457. doi: 10.1158/1078-0432.CCR-17-1449. Epub 2017 Jul 28.

Abstract

Research biopsies are frequently incorporated within clinical trials in oncology and are often a mandatory requirement for trial enrollment. However, limited information is available regarding the extent and completeness of research biopsy reporting. We identified a cohort of therapeutic clinical trials where research biopsies were performed between January 2005 and October 2010 from an IR database at our institution. Clinical trial protocols were compared with the highest level of corresponding publication as a manuscript or registry report. A total of 866 research biopsies were performed across 46 clinical trials, with a median of 8 patients biopsied/trial and 19 biopsies collected/trial. After a median follow-up time of 4.3 years from trial completion, 36 of 46 trials (78%) reported trial results: published manuscripts ( = 35), or registry report ( = 1). A total of 635 conducted biopsies were reported in 18 of the 46 trials (39%). Six (33%) of these 18 trials underreported the number of biopsies performed. Of 33 trials with mandatory research biopsies, 13 (39%) trials reported on these biopsies. Biopsy complications occurred in 8 trials [ = 39 patients, 6 grade 3/4 adverse events (AE)] but only 1 trial reported these. Factors associated with biopsy reporting included a larger number of biopsies ( ≤ 0.001) and serial biopsies ( < 0.001). Twelve of 16 (75%) trials with >12 biopsies performed reported on these biopsies compared with only 20% (6/30) that performed ≤12 biopsies. Despite ethical obligations to report research biopsies, the majority (61%) of trials do not report results from research biopsies. Complications are rarely reported in these studies. Improved reporting of results and AEs from research biopsies is needed. .

摘要

研究活检经常被纳入肿瘤学的临床试验中,并且通常是试验入组的强制性要求。然而,关于研究活检报告的范围和完整性的信息有限。我们从机构的 IR 数据库中确定了一组在 2005 年 1 月至 2010 年 10 月期间进行的治疗性临床试验,其中进行了研究活检。将临床试验方案与最高级别的相应出版物(手稿或注册报告)进行比较。在临床试验完成后的中位随访时间为 4.3 年后,46 项临床试验中有 36 项(78%)报告了试验结果:发表的手稿(n=35)或注册报告(n=1)。46 项试验中的 18 项报告了 635 项已进行的活检(39%)。这 18 项试验中有 6 项(33%)报告的活检数量少于实际数量。在 33 项有强制性研究活检的试验中,有 13 项(39%)报告了这些活检。8 项试验中出现了活检并发症[n=39 例,6 例 3/4 级不良事件(AE)],但只有 1 项试验报告了这些并发症。与活检报告相关的因素包括活检数量较多(≤0.001)和连续活检(<0.001)。在 16 项活检次数超过 12 次的试验中,有 12 项(75%)报告了这些活检,而在活检次数≤12 次的试验中,只有 20%(6/30)报告了这些活检。尽管有报告研究活检的伦理义务,但大多数(61%)试验未报告研究活检的结果。这些研究中很少报告并发症。需要改善研究活检结果和 AE 的报告。

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