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2012 - 2021年注册乳腺癌试验中老年亚组的报告

Reporting of older subgroups in registration breast cancer trials 2012-2021.

作者信息

Eochagain Colm Mac, Battisti Nicolò Matteo Luca

机构信息

Breast Cancer Unit, Royal Marsden Hospital, Sutton, London, UK.

出版信息

Breast Cancer Res Treat. 2023 Dec;202(3):411-421. doi: 10.1007/s10549-023-07081-0. Epub 2023 Sep 4.

Abstract

INTRODUCTION

Adequate reporting of data specific to older populations enrolled to breast cancer trials is critical, given the high incidence of the disease among this demographic. This study aimed to examine the completeness of reporting of older subgroups among patients recruited to registration clinical trials investigating systemic treatments for breast cancer.

METHODS

Clinical trials leading to a US food and drug administration (FDA) approval in breast cancer between 2012 and 2021 were included. Primary study reports and and all available secondary publications were systematically and objectively assessed with regard to the availability of data regarding efficacy, baseline characteristics, safety, and health-related quality of life (HRQOL) outcomes among older subgroups.

RESULTS

27 trials and 216 publications were assessed. 20.3% of patients were aged ≥65. 70.0% of patients had an eastern cooperative oncology group (ECOG) performance status of 0. Although complete reporting of primary endpoints was adequate (72.7%), most protocol-defined primary endpoints were surrogate endpoints (84.8%). Overall survival data among older populations was unavailable in 50.0% of studies. Reporting was poor for secondary efficacy endpoints (81.8% unreported), baseline characteristics (70.4% unreported), toxicity (55.6% unreported), and health-related quality of life outcomes (87.5% unreported).

CONCLUSION

The findings underline significant deficits in the reporting of age-specific data in breast cancer registration trials. The underreporting of key efficacy, safety, and HRQOL outcomes highlights the need for mandatory reporting standards and a dedicated emphasis on older populations' priorities and needs in the reporting of registration clinical trials.

摘要

引言

鉴于乳腺癌在老年人群中的高发病率,充分报告纳入乳腺癌试验的老年人群的特定数据至关重要。本研究旨在检查在招募接受乳腺癌全身治疗的注册临床试验患者中,老年亚组报告的完整性。

方法

纳入2012年至2021年间导致美国食品药品监督管理局(FDA)批准的乳腺癌临床试验。对主要研究报告和所有可用的二次出版物进行系统且客观的评估,以了解老年亚组中疗效、基线特征、安全性及健康相关生活质量(HRQOL)结局的数据可用性。

结果

评估了27项试验和216篇出版物。20.3%的患者年龄≥65岁。70.0%的患者东部肿瘤协作组(ECOG)体能状态为0。虽然主要终点的完整报告情况尚可(72.7%),但大多数方案定义的主要终点是替代终点(84.8%)。50.0%的研究未提供老年人群的总生存数据。次要疗效终点(81.8%未报告)、基线特征(70.4%未报告)、毒性(55.6%未报告)以及健康相关生活质量结局(87.5%未报告)的报告情况较差。

结论

研究结果突显了乳腺癌注册试验中特定年龄数据报告存在重大缺陷。关键疗效、安全性和HRQOL结局报告不足,凸显了制定强制性报告标准的必要性,以及在注册临床试验报告中专门关注老年人群的优先事项和需求的必要性。

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