在新辅助剂或辅助剂FDA注册试验中的复发后治疗:系统性审查
Timothée Olivier1, Alyson Haslam2, Vinay Prasad2
1Department of Oncology, Geneva University Hospital, Geneva, Switzerland.
JAMA oncology
|June 20, 2024
概括
许多瘤学临床试验缺乏关于复发后治疗的数据,如果有,它往往是不理想的. 这凸显了监管机构需要确保患者在癌症复发时获得最好的癌症护理的需要.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 癌症治疗方法 癌症治疗方法
背景情况:
- 在瘤随机临床试验中,在复发时获得最佳可用护理的低最佳准入可能会影响整体存活率.
- 评估复发后治疗的质量和比例对于患者的治疗结果至关重要.
研究的目的:
- 评估美国食品和药物管理局 (FDA) 注册试验中的患者复发后治疗的比例和质量.
- 在辅助或新辅助环境中分析系统治疗试验.
主要方法:
- 对FDA导致药物批准的试验进行系统审查 (2018年1月 - 2023年5月).
- 在新辅助或辅助环境中对抗癌药物的随机临床试验的纳入.
- 不包括支持性护理和放射治疗组合试验.
主要成果:
- 14个FDA试验符合纳入标准.
- 在43%的试验中,没有复发后的数据.
- 当可用时,复发后的治疗在75%的病例中是不理想的;只有14%是适当的.
结论:
- 在瘤学试验中,报告复发后治疗数据存在重大差距.
- 在报告数据时,低于最佳的复发后治疗普遍存在.
- 监管机构应授权在复发时获得最佳护理.
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