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针对 III-IV 期黑色素瘤采用靶向治疗或免疫治疗的患者的健康相关生活质量:对 III 期随机对照试验中报告的充分性和临床问题的系统评价。

Health-related quality of life in stage III-IV melanoma treated with targeted therapy or immunotherapy: A systematic review on the adequacy of reporting and clinical issues in phase III randomized controlled trials.

机构信息

Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Cancer Institute, University College London, London, UK.

出版信息

Cancer Med. 2023 Feb;12(3):2262-2280. doi: 10.1002/cam4.5183. Epub 2022 Aug 28.

Abstract

Cutaneous melanoma represents around over 90% of all melanoma. With more effective treatments able to extend patients' survival, health-related quality of life (HRQOL) is increasingly becoming an important endpoint in cancer clinical trials. They are often secondary outcomes measured in phase III randomized controlled trials and their implementation, collection, analysis, and reporting can be challenging methodologically. For these reasons, an increasing number of international recommendations introduced the standards regarding the conduct of HRQOL. In this systematic review, we appraise the adequacy of HRQOL reporting in phase III randomized controlled trials of stage III-IV cutaneous melanoma and the clinical issues of immunotherapy and small-molecular-targeted therapy on HRQOL. Our search strategy totally got 55 articles, and only 13 studies met all inclusion criteria. Findings suggest that most treatments did not yield significant improvements in HRQOL but kept baseline levels, accompanied by prolonged survival and acceptable toxicity. Except for some existing limitations, reporting of HRQOL has made encouraging progress during the period covered by our search, but some aspects still need further optimization.

摘要

皮肤黑色素瘤占所有黑色素瘤的 90%以上。随着更有效的治疗方法能够延长患者的生存时间,健康相关生活质量(HRQOL)在癌症临床试验中越来越成为一个重要的终点。它们通常是 III 期随机对照试验中测量的次要结局,其实施、收集、分析和报告在方法学上可能具有挑战性。出于这些原因,越来越多的国际建议引入了关于 HRQOL 实施的标准。在这项系统评价中,我们评估了 III 期随机对照试验中 III 期-IV 期皮肤黑色素瘤的 HRQOL 报告的充分性,以及免疫疗法和小分子靶向治疗对 HRQOL 的临床问题。我们的搜索策略总共得到了 55 篇文章,但只有 13 项研究符合所有纳入标准。研究结果表明,大多数治疗方法并没有显著改善 HRQOL,而是保持了基线水平,同时延长了生存时间并可接受毒性。除了一些现有的局限性,在我们搜索的时间段内,HRQOL 的报告已经取得了令人鼓舞的进展,但仍有一些方面需要进一步优化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1d/9939121/40dd6bea299c/CAM4-12-2262-g001.jpg

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