在新辅助乳腺癌临床试验中有效性终点的标准化定义:NeoSTEEP
Jennifer K Litton1, Meredith M Regan2, Lajos Pusztai3
1Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
概括
新的指导方针标准化了新辅助乳腺癌试验的疗效终点. NeoSTEEP工作组推一种病理完整反应 (pCR) 的首选定义,并强调为更好的乳腺癌研究提供标准化试验设计.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 生物统计学 生物统计学
背景情况:
- 在2021年更新的有效性终点标准 (STEEP) 标准标准化定义中,确定了辅助乳腺癌 (BC) 终点的定义.
- STEEP 2.0强调了在新辅助性BC临床试验中需要明确的终点.
研究的目的:
- 批判性地评估和对准新辅助乳腺癌临床试验的终点.
- 在新辅助全身疗法试验中制定有效性结果的标准化定义.
主要方法:
- 一个多学科的NeoSTEEP专家工作组召开了会议.
- 专注于新辅助系统治疗的终点,包括病理和时间到事件的生存结果.
- 考虑了亚型特定需求,成像,节点分期和监管因素.
主要成果:
- 建议将病理完整反应 (pCR) 定义为乳腺和淋巴结 (ypT0/Tis ypN0) 中没有残留的侵入性癌症.
- 建议剩余癌症负担作为二次终点,并呼吁为激素受体阳性疾病提供替代终点.
- 倡导从随机分配 (无事件生存率,整体生存率) 来测量的时间到事件终点,以捕捉早期事件.
结论:
- 终点选择应与瘤生物学和治疗剂保持一致.
- 一致的,预先规定的定义和干预措施对于有意义的试验结果和跨试验比较至关重要.
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