Department of Medical Oncology, Cancer Center, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Department of Surgery, Cancer Center, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
JAMA Oncol. 2022 Jun 1;8(6):929-937. doi: 10.1001/jamaoncol.2022.0168.
Pancreatic cancer is the third most common cause of cancer death; however, randomized clinical trials (RCTs) of survival in patients with resectable pancreatic cancer lack mandatory measures for reporting baseline and prognostic factors, which hampers comparisons between outcome measures.
To develop a consensus on baseline and prognostic factors to be used as mandatory measurements in RCTs of resectable and borderline resectable pancreatic cancer.
We performed a systematic literature search of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Embase for RCTs on resectable and borderline resectable pancreatic cancer with overall survival as the primary outcome. We produced a systematic summary of all baseline and prognostic factors identified in the RCTs. A Delphi panel that included 13 experts was surveyed to reach a consensus on mandatory and recommended baseline and prognostic factors.
The 42 RCTs that met inclusion criteria reported a total of 60 baseline and 19 prognostic factors. After 2 Delphi rounds, agreement was reached on 50 mandatory baseline and 20 mandatory prognostic factors for future RCTs, with a distinction between studies of neoadjuvant vs adjuvant treatment.
This findings of this systematic review and international expert consensus have produced this Consensus Statement on Mandatory Measurements in Pancreatic Cancer Trials for Resectable and Borderline Resectable Disease (COMM-PACT-RB). The baseline and prognostic factors comprising the mandatory measures will facilitate better comparison across RCTs and eventually will enable improved clinical practice among patients with resectable and borderline resectable pancreatic cancer.
胰腺癌是癌症死亡的第三大常见原因;然而,可切除胰腺癌患者生存的随机临床试验 (RCT) 缺乏报告基线和预后因素的强制性措施,这阻碍了对结果衡量标准的比较。
就可切除和边缘可切除胰腺癌 RCT 中用作强制性测量的基线和预后因素达成共识。
我们对 Cochrane 对照试验中心注册库 (CENTRAL)、PubMed 和 Embase 中可切除和边缘可切除胰腺癌的 RCT 进行了系统文献检索,以总生存为主要结局。我们对 RCT 中确定的所有基线和预后因素进行了系统总结。一个包括 13 名专家的 Delphi 小组接受了调查,以就强制性和推荐的基线和预后因素达成共识。
符合纳入标准的 42 项 RCT 共报告了 60 个基线和 19 个预后因素。经过 2 轮 Delphi 调查,达成了 50 项强制性基线和 20 项强制性预后因素的共识,这些因素区分了新辅助治疗和辅助治疗的研究。
本系统评价和国际专家共识的结果产生了本可切除和边缘可切除疾病 (COMM-PACT-RB) 胰腺肿瘤试验强制性测量共识声明。构成强制性措施的基线和预后因素将促进 RCT 之间更好的比较,并最终为可切除和边缘可切除胰腺癌患者的临床实践提供改进。