Moving Beyond Conventional Clinical Trial End Points in Treatment-refractory Metastatic Colorectal Cancer: A Composite Quality-of-life and Symptom Control End Point
| Autor: | Andrew Eugene Hendifar, John Simard, Richard Tuli, Daniel Wu, Jeremy Chuang, Jun Gong |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Population MEDLINE 03 medical and health sciences 0302 clinical medicine Quality of life medicine Clinical endpoint Humans Pharmacology (medical) 030212 general & internal medicine Intensive care medicine Prospective cohort study education Fatigue Randomized Controlled Trials as Topic Pharmacology education.field_of_study business.industry medicine.disease Clinical trial 030220 oncology & carcinogenesis Physical therapy Quality of Life Observational study business Colorectal Neoplasms |
| Zdroj: | Clinical therapeutics. 39(11) |
| ISSN: | 1879-114X |
| Popis: | Purpose This review highlights the evidence supporting symptom control and quality-of-life (QOL) measures as predictors of survival in treatment-refractory metastatic colorectal cancer (mCRC) and describes a composite symptom control and QOL end point recently reported in a Phase III trial that may serve as a more reasonable end point of efficacy in this population. Methods A literature search was conducted using MEDLINE to identify clinical studies (including case series and observational, retrospective, and prospective studies) that reported the predictive value of QOL measures for survival in mCRC. The search was limited by the following key words: quality of life , survival , and colorectal cancer . We then performed a second search limited to studies of randomized and Phase III design in mCRC to identify studies that used QOL assessments as their primary end points. A manual search was also performed to include additional studies of potential relevance. Findings There is increasing evidence to support that symptom control and QOL measures are predictors of survival in treatment-refractory mCRC and can serve as an alternative but equally as important end point to survival in this population. A recent large, randomized Phase III trial using a composite primary end point of lean body mass, pain, anorexia, and fatigue reported the feasibility in evaluating benefit in mCRC beyond conventional clinical trial end points. Implications Future studies in treatment-refractory mCRC may be better served by evaluating improvement in symptom control and QOL, which may otherwise serve as the best predictor of survival in last-line treatment settings. |
| Databáze: | OpenAIRE |
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