Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Oncology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Haukeland University Hospital, Bergen, Norway.
Eur J Cancer. 2018 Sep;100:35-45. doi: 10.1016/j.ejca.2018.05.010. Epub 2018 Jun 22.
Patient characteristics and stratification factors are key features influencing trial outcomes. However, there is substantial heterogeneity in reporting of patient characteristics and use of stratification factors in phase 3 trials investigating systemic treatment of metastatic colorectal cancer (mCRC). We aimed to develop a minimum set of essential baseline characteristics and stratification factors to include in such trials.
We performed a modified, two-round Delphi survey among international experts with wide experience in the conduct and methodology of phase 3 trials of systemic treatment of mCRC.
Thirty mCRC experts from 15 different countries completed both consensus rounds. A total of 14 patient characteristics were included in the recommended set: age, performance status, primary tumour location, primary tumour resection, prior chemotherapy, number of metastatic sites, liver-only disease, liver involvement, surgical resection of metastases, synchronous versus metachronous metastases, (K)RAS and BRAF mutation status, microsatellite instability/mismatch repair status and number of prior treatment lines. A total of five patient characteristics were considered the most relevant stratification factors: RAS/BRAF mutation status, performance status, primary tumour sidedness and liver-only disease.
This survey provides a minimum set of essential baseline patient characteristics and stratification factors to include in phase 3 trials of systemic treatment of mCRC. Inclusion of these patient characteristics and strata in study protocols and final study reports will improve interpretation of trial results and facilitate cross-study comparisons.
患者特征和分层因素是影响试验结果的关键特征。然而,在研究转移性结直肠癌(mCRC)系统治疗的 3 期试验中,报告患者特征和使用分层因素存在很大的异质性。我们旨在制定一套包含在这些试验中的基本必备基线特征和分层因素。
我们对在 mCRC 系统治疗的 3 期试验的实施和方法方面具有广泛经验的国际专家进行了一项改良的两轮德尔菲调查。
来自 15 个不同国家的 30 名 mCRC 专家完成了两轮共识调查。推荐的一组共包含 14 个患者特征:年龄、体能状态、原发肿瘤部位、原发肿瘤切除、既往化疗、转移部位数量、肝转移、肝受累、转移灶的手术切除、同步或异时转移、(K)RAS 和 BRAF 突变状态、微卫星不稳定性/错配修复状态和既往治疗线数。共有 5 个患者特征被认为是最相关的分层因素:RAS/BRAF 突变状态、体能状态、原发肿瘤侧和肝转移。
这项调查提供了一套包含在 mCRC 系统治疗的 3 期试验中的基本必备基线患者特征和分层因素。在研究方案和最终研究报告中纳入这些患者特征和分层因素,将有助于解释试验结果,并促进跨研究比较。