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Erschienen in: Lung 4/2013

01.08.2013

Reporting Trends of Outcome Measures in Phase II and Phase III Trials Conducted in Advanced-Stage Non-small-cell Lung Cancer

verfasst von: Saurav Ghimire, Eunjung Kyung, Eunyoung Kim

Erschienen in: Lung | Ausgabe 4/2013

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Abstract

Background

The methodology of conducting clinical trials in lung cancer has been challenged by the particular characteristics of new targeted agents. Thus, the choice of correct outcome measures and selection of best study designs are essential. We assessed the trends in reporting of outcome measures in phase II and phase III trials conducted in advanced non-small-cell lung cancer (NSCLC) patients.

Methods

Data from September 2000 to September 2012 were extracted from the ClinicalTrials.gov database, and a descriptive–comparative analysis was performed to evaluate outcome-measures reporting for the two phases.

Results

We identified 459 phase II and 128 phase III trials that met our inclusion criteria. The frequently reported primary outcomes in phase II trials were progression-free survival (PFS; 32 %), response rate (RR; 21.4 %), and safety and toxicity (adverse events [AEs]; 14.6 %). In contrast, overall survival (OS; 60.9 %) and PFS (26.6 %) were frequently reported primary outcomes in phase III trials. AEs were reported as a secondary outcome measure in 50.1 and 64.8 % of phase II and phase III trials, respectively. Improvement in quality of life was identified as a secondary outcome measure significantly more frequently in phase III than in phase II trials.

Conclusions

Our study identified recent trends in reports of outcome measures in advanced-stage NSCLC phase II and phase III trials. The outcomes of this study can be valuable for investigators with minimal or some experience in the field of oncology who are conducting clinical research.
Literatur
2.
Zurück zum Zitat Inoue K, Narukawa M, Takeuchi M (2012) Factors affecting efficacy and safety of add-on combination chemotherapy for non-small-cell lung cancer: a literature-based pooled analysis of randomized controlled trials. Lung 190(4):355–364. doi:10.1007/s00408-012-9379-7 PubMedCrossRef Inoue K, Narukawa M, Takeuchi M (2012) Factors affecting efficacy and safety of add-on combination chemotherapy for non-small-cell lung cancer: a literature-based pooled analysis of randomized controlled trials. Lung 190(4):355–364. doi:10.​1007/​s00408-012-9379-7 PubMedCrossRef
3.
Zurück zum Zitat Non-small Cell Lung Cancer Collaborative Group (1995) Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ 311(7010):899–909. doi:10.1136/bmj.311.7010.899 Non-small Cell Lung Cancer Collaborative Group (1995) Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ 311(7010):899–909. doi:10.​1136/​bmj.​311.​7010.​899
4.
Zurück zum Zitat Johnson JR, Williams G, Pazdur R (2003) End points and United States Food and Drug Administration approval of oncology drugs. J Clin Oncol 21(7):1404–1411PubMedCrossRef Johnson JR, Williams G, Pazdur R (2003) End points and United States Food and Drug Administration approval of oncology drugs. J Clin Oncol 21(7):1404–1411PubMedCrossRef
6.
Zurück zum Zitat Pilz LR, Manegold C, Schmid-Bindert G (2012) Statistical considerations and endpoints for clinical lung cancer studies: can progression free survival (PFS) substitute overall survival (OS) as a valid endpoint in clinical trials for advanced non-small-cell lung cancer? Transl Lung Cancer Res 1:26–35. doi:10.3978/j.issn.2218-6751.2011.12.08 Pilz LR, Manegold C, Schmid-Bindert G (2012) Statistical considerations and endpoints for clinical lung cancer studies: can progression free survival (PFS) substitute overall survival (OS) as a valid endpoint in clinical trials for advanced non-small-cell lung cancer? Transl Lung Cancer Res 1:26–35. doi:10.​3978/​j.​issn.​2218-6751.​2011.​12.​08
7.
Zurück zum Zitat Nottage M, Siu LL (2002) Principles of clinical trial design. J Clin Oncol 20(18 Suppl):42S–46SPubMed Nottage M, Siu LL (2002) Principles of clinical trial design. J Clin Oncol 20(18 Suppl):42S–46SPubMed
8.
11.
Zurück zum Zitat Mariani L, Marubini E (2000) Content and quality of currently published phase II cancer trials. J Clin Oncol 18(2):429–436PubMed Mariani L, Marubini E (2000) Content and quality of currently published phase II cancer trials. J Clin Oncol 18(2):429–436PubMed
13.
Zurück zum Zitat Buyse M, Thirion P, Carlson RW, Burzykowski T, Molenberghs G, Piedbois P (2000) Relation between tumour response to first-line chemotherapy and survival in advanced colorectal cancer: a meta-analysis. Meta-analysis group in cancer. Lancet 356(9227):373–378PubMedCrossRef Buyse M, Thirion P, Carlson RW, Burzykowski T, Molenberghs G, Piedbois P (2000) Relation between tumour response to first-line chemotherapy and survival in advanced colorectal cancer: a meta-analysis. Meta-analysis group in cancer. Lancet 356(9227):373–378PubMedCrossRef
15.
Zurück zum Zitat Nishino M, Jagannathan JP, Krajewski KM, O’Regan K, Hatabu H, Shapiro G, Ramaiya NH (2012) Personalized tumor response assessment in the era of molecular medicine: cancer-specific and therapy-specific response criteria to complement pitfalls of RECIST. AJR Am J Roentgenol 198(4):737–745. doi:10.2214/ajr.11.7483 PubMedCrossRef Nishino M, Jagannathan JP, Krajewski KM, O’Regan K, Hatabu H, Shapiro G, Ramaiya NH (2012) Personalized tumor response assessment in the era of molecular medicine: cancer-specific and therapy-specific response criteria to complement pitfalls of RECIST. AJR Am J Roentgenol 198(4):737–745. doi:10.​2214/​ajr.​11.​7483 PubMedCrossRef
16.
Zurück zum Zitat Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S, Campos D, Maoleekoonpiroj S, Smylie M, Martins R, van Kooten M, Dediu M, Findlay B, Tu D, Johnston D, Bezjak A, Clark G, Santabarbara P, Seymour L, National Cancer Institute of Canada Clinical Trials G (205) Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353(2):123–132. doi:10.1056/NEJMoa050753 CrossRef Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S, Campos D, Maoleekoonpiroj S, Smylie M, Martins R, van Kooten M, Dediu M, Findlay B, Tu D, Johnston D, Bezjak A, Clark G, Santabarbara P, Seymour L, National Cancer Institute of Canada Clinical Trials G (205) Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353(2):123–132. doi:10.​1056/​NEJMoa050753 CrossRef
18.
Zurück zum Zitat Ratain MJ, Eisen T, Stadler WM, Flaherty KT, Kaye SB, Rosner GL, Gore M, Desai AA, Patnaik A, Xiong HQ, Rowinsky E, Abbruzzese JL, Xia C, Simantov R, Schwartz B, O’Dwyer PJ (2006) Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol 24(16):2505–2512. doi:10.1200/jco.2005.03.6723 PubMedCrossRef Ratain MJ, Eisen T, Stadler WM, Flaherty KT, Kaye SB, Rosner GL, Gore M, Desai AA, Patnaik A, Xiong HQ, Rowinsky E, Abbruzzese JL, Xia C, Simantov R, Schwartz B, O’Dwyer PJ (2006) Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol 24(16):2505–2512. doi:10.​1200/​jco.​2005.​03.​6723 PubMedCrossRef
19.
Zurück zum Zitat Abou-Alfa GK, Schwartz L, Ricci S, Amadori D, Santoro A, Figer A, De Greve J, Douillard JY, Lathia C, Schwartz B, Taylor I, Moscovici M, Saltz LB (2006) Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol 24(26):4293–4300. doi:10.1200/jco.2005.01.3441 PubMedCrossRef Abou-Alfa GK, Schwartz L, Ricci S, Amadori D, Santoro A, Figer A, De Greve J, Douillard JY, Lathia C, Schwartz B, Taylor I, Moscovici M, Saltz LB (2006) Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol 24(26):4293–4300. doi:10.​1200/​jco.​2005.​01.​3441 PubMedCrossRef
20.
Zurück zum Zitat Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, Negrier S, Chevreau C, Solska E, Desai AA, Rolland F, Demkow T, Hutson TE, Gore M, Freeman S, Schwartz B, Shan M, Simantov R, Bukowski RM, Group TS (2007) Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 356(2):125–134. doi:10.1056/NEJMoa060655 PubMedCrossRef Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, Negrier S, Chevreau C, Solska E, Desai AA, Rolland F, Demkow T, Hutson TE, Gore M, Freeman S, Schwartz B, Shan M, Simantov R, Bukowski RM, Group TS (2007) Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 356(2):125–134. doi:10.​1056/​NEJMoa060655 PubMedCrossRef
21.
Zurück zum Zitat Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, Schwartz M, Porta C, Zeuzem S, Bolondi L, Greten TF, Galle PR, Seitz JF, Borbath I, Haussinger D, Giannaris T, Shan M, Moscovici M, Voliotis D, Bruix J, Group SIS (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359(4):378–390. doi:10.1056/NEJMoa0708857 PubMedCrossRef Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, Schwartz M, Porta C, Zeuzem S, Bolondi L, Greten TF, Galle PR, Seitz JF, Borbath I, Haussinger D, Giannaris T, Shan M, Moscovici M, Voliotis D, Bruix J, Group SIS (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359(4):378–390. doi:10.​1056/​NEJMoa0708857 PubMedCrossRef
24.
Zurück zum Zitat Wu W, Sargent D (2010) Choice of endpoints in cancer clinical trials. In: Kelly WK, Halabi S (eds) Oncology clinical trials. Successful design, conduct, and analysis. Demos Medical Publishing, New York, pp 35–42 Wu W, Sargent D (2010) Choice of endpoints in cancer clinical trials. In: Kelly WK, Halabi S (eds) Oncology clinical trials. Successful design, conduct, and analysis. Demos Medical Publishing, New York, pp 35–42
26.
Zurück zum Zitat Hunsberger S, Albert PS, Dodd L (2010) Analysis of progression-free survival data using a discrete time survival model that incorporates measurements with and without diagnostic error. Clin Trials 7(6):634–642. doi:10.1177/1740774510384887 PubMedCrossRef Hunsberger S, Albert PS, Dodd L (2010) Analysis of progression-free survival data using a discrete time survival model that incorporates measurements with and without diagnostic error. Clin Trials 7(6):634–642. doi:10.​1177/​1740774510384887​ PubMedCrossRef
28.
30.
Zurück zum Zitat Fleming TR, DeMets DL (1996) Surrogate end points in clinical trials: are we being misled? Ann Intern Med 125(7):605–613PubMedCrossRef Fleming TR, DeMets DL (1996) Surrogate end points in clinical trials: are we being misled? Ann Intern Med 125(7):605–613PubMedCrossRef
31.
Zurück zum Zitat Laporte S, Squifflet P, Baroux N, Fossella F, Georgoulias V, Pujol JL, Douillard JY, Kudoh S, Pignon JP, Quinaux E, Buyse M (2013) Prediction of survival benefits from progression-free survival benefits in advanced non-small-cell lung cancer: evidence from a meta-analysis of 2,334 patients from 5 randomised trials. BMJ Open 3(3):e001802. doi:10.1136/bmjopen-2012-001802 PubMedCrossRef Laporte S, Squifflet P, Baroux N, Fossella F, Georgoulias V, Pujol JL, Douillard JY, Kudoh S, Pignon JP, Quinaux E, Buyse M (2013) Prediction of survival benefits from progression-free survival benefits in advanced non-small-cell lung cancer: evidence from a meta-analysis of 2,334 patients from 5 randomised trials. BMJ Open 3(3):e001802. doi:10.​1136/​bmjopen-2012-001802 PubMedCrossRef
32.
Zurück zum Zitat Hotta K, Suzuki E, Di Maio M, Chiodini P, Fujiwara Y, Takigawa N, Ichihara E, Reck M, Manegold C, Pilz L, Hisamoto-Sato A, Tabata M, Tanimoto M, Shepherd FA, Kiura K (2012) Progression-free survival and overall survival in phase III trials of molecular-targeted agents in advanced non-small-cell lung cancer. Lung Cancer 79(1):20–26. doi:10.1016/j.lungcan.2012.10.007 PubMedCrossRef Hotta K, Suzuki E, Di Maio M, Chiodini P, Fujiwara Y, Takigawa N, Ichihara E, Reck M, Manegold C, Pilz L, Hisamoto-Sato A, Tabata M, Tanimoto M, Shepherd FA, Kiura K (2012) Progression-free survival and overall survival in phase III trials of molecular-targeted agents in advanced non-small-cell lung cancer. Lung Cancer 79(1):20–26. doi:10.​1016/​j.​lungcan.​2012.​10.​007 PubMedCrossRef
34.
Zurück zum Zitat Temel J (2007) Complexities of quality of life analysis in non-small cell lung cancer. J Support Oncol 5(1):30–31PubMed Temel J (2007) Complexities of quality of life analysis in non-small cell lung cancer. J Support Oncol 5(1):30–31PubMed
36.
Zurück zum Zitat Gralla RJ, Thatcher N (2004) Quality-of-life assessment in advanced lung cancer: considerations for evaluation in patients receiving chemotherapy. Lung Cancer 46(Suppl 2):S41–S47PubMedCrossRef Gralla RJ, Thatcher N (2004) Quality-of-life assessment in advanced lung cancer: considerations for evaluation in patients receiving chemotherapy. Lung Cancer 46(Suppl 2):S41–S47PubMedCrossRef
37.
Zurück zum Zitat Claassens L, van Meerbeeck J, Coens C, Quinten C, Ghislain I, Sloan EK, Wang XS, Velikova G, Bottomley A (2011) Health-related quality of life in non-small-cell lung cancer: an update of a systematic review on methodologic issues in randomized controlled trials. J Clin Oncol 29(15):2104–2120. doi:10.1200/jco.2010.32.3683 PubMedCrossRef Claassens L, van Meerbeeck J, Coens C, Quinten C, Ghislain I, Sloan EK, Wang XS, Velikova G, Bottomley A (2011) Health-related quality of life in non-small-cell lung cancer: an update of a systematic review on methodologic issues in randomized controlled trials. J Clin Oncol 29(15):2104–2120. doi:10.​1200/​jco.​2010.​32.​3683 PubMedCrossRef
38.
Zurück zum Zitat Reynolds T (2000) Eliminating publication bias: the effect of negative trial results. J Natl Cancer Inst 92(9):682PubMedCrossRef Reynolds T (2000) Eliminating publication bias: the effect of negative trial results. J Natl Cancer Inst 92(9):682PubMedCrossRef
Metadaten
Titel
Reporting Trends of Outcome Measures in Phase II and Phase III Trials Conducted in Advanced-Stage Non-small-cell Lung Cancer
verfasst von
Saurav Ghimire
Eunjung Kyung
Eunyoung Kim
Publikationsdatum
01.08.2013
Verlag
Springer US
Erschienen in
Lung / Ausgabe 4/2013
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-013-9479-z

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