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癌症药物注册临床试验中的健康相关生命质量数据:超越报销的价值。

Health-Related Quality of Life Data in Cancer Clinical Trials for Drug Registration: The Value Beyond Reimbursement.

机构信息

Rutgers The State University of New Jersey, School of Health Professions, Department of Interdisciplinary Studies, 65 Bergen Street, Newark, NJ 07107-1709.

Rutgers The State University of New Jersey, School of Health Professions, Department of Clinical Laboratory and Medical Imaging Sciences, 65 Bergen Street, Newark, NJ 07107-1709.

出版信息

JCO Clin Cancer Inform. 2021 Jan;5:112-124. doi: 10.1200/CCI.20.00100.

Abstract

PURPOSE

A review of the literature was performed to evaluate how quality of life measures are collected, analyzed, and reported in cancer clinical trials intended to support drug registration.Health-related quality of life (HRQoL) data points are one of the patient-reported outcome (PRO) assessments used in clinical trials to evaluate the effects of treatments from the patient perspective. The use of PROs has gained focus in cancer clinical trials as more options become available for greater longevity of patients on treatment. Standardization of PRO data is evolving and involves unique challenges when used for assessing biologic and chemotherapeutic agents for the treatment of cancer.

METHODS

In this study, a review of literature published between 2009 and 2019 was conducted using PubMed, COCHRANE Library, and Medline. The research focus was on the current guidance, implementation, and reporting as well as highlighting the issues, and recommendations for the inclusion of HRQoL end points in cancer clinical trials intended for use in drug registration.

RESULTS

Although there exist many levels of guidance for HRQoL measures in cancer drug trials, challenges to operational implementation, the current inconsistent adherence to reporting standards, and the lack of consensus and understanding of analyses limit the value and potential of the resulting data collected.

CONCLUSION

The results of HRQoL data collected from cancer clinical trials can be difficult to interpret and apply to inform clinical decision making. Increased reporting and access to these data can provide opportunities for potential applications to improve translatability of HRQoL data collected in clinical trials into practice.

摘要

目的

本文对文献进行了回顾,以评估旨在支持药物注册的癌症临床试验中如何收集、分析和报告生活质量测量结果。健康相关生活质量(HRQoL)数据是临床试验中用于从患者角度评估治疗效果的患者报告结局(PRO)评估之一。随着接受治疗的患者寿命延长,可供选择的治疗方案增多,PRO 在癌症临床试验中的应用得到了重视。PRO 的标准化正在不断发展,当用于评估用于治疗癌症的生物和化疗药物时,涉及到独特的挑战。

方法

本研究使用 PubMed、COCHRANE 图书馆和 Medline 对 2009 年至 2019 年期间发表的文献进行了回顾。研究重点是当前的指导、实施和报告,以及突出存在的问题,并就将 HRQoL 终点纳入旨在用于药物注册的癌症临床试验提出建议。

结果

尽管癌症药物试验中存在许多 HRQoL 测量的指导水平,但在操作实施方面存在挑战、目前对报告标准的一致性较差以及对分析的共识和理解缺乏限制了收集到的数据的价值和潜力。

结论

从癌症临床试验中收集的 HRQoL 数据的解释和应用都很困难,无法为临床决策提供信息。增加对这些数据的报告和获取可以为潜在应用提供机会,以提高临床试验中收集的 HRQoL 数据在实践中的可转化性。

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