SWOG Cancer Research Network and Fred Hutchinson Cancer Research Center, Seattle, WA.
Biometric Research Program, National Cancer Institute, Bethesda, MD.
J Clin Oncol. 2024 Nov;42(31):3753-3760. doi: 10.1200/JCO.24.00025. Epub 2024 May 17.
New oncology therapies that extend patients' lives beyond initial expectations and improving later-line treatments can lead to complications in clinical trial design and conduct. In particular, for trials with event-based analyses, the time to observe all the protocol-specified events can exceed the finite follow-up of a clinical trial or can lead to much delayed release of outcome data. With the advent of multiple classes of oncology therapies leading to much longer survival than in the past, this issue in clinical trial design and conduct has become increasingly important in recent years. We propose a straightforward prespecified backstop rule for trials with a time-to-event analysis and evaluate the impact of the rule with both simulated and real-world trial data. We then provide recommendations for implementing the rule across a range of oncology clinical trial settings.
新的肿瘤学疗法延长了患者的预期寿命,改善了后线治疗,这可能导致临床试验设计和实施出现并发症。特别是对于基于事件分析的试验,观察所有协议规定事件的时间可能超过临床试验的有限随访时间,或者导致结果数据延迟发布。随着多种肿瘤学治疗方法的出现,患者的生存时间比过去大大延长,因此,近年来,临床试验设计和实施中的这个问题变得越来越重要。我们为具有时间事件分析的试验提出了一个简单的预设后备规则,并使用模拟和真实世界的试验数据评估了该规则的影响。然后,我们为在一系列肿瘤学临床试验环境中实施该规则提供了建议。