1
|
Teixeira da Silva JA. Issues and challenges to reproducibility of cancer research: a commentary. Future Oncol 2022; 18:1417-1422. [DOI: 10.2217/fon-2021-1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
2
|
Lengliné E, Peron J, Vanier A, Gueyffier F, Kouzan S, Dufour P, Guillot B, Blondon H, Clanet M, Cochat P, Degos F, Chevret S, Grande M, Putzolu J. Basket clinical trial design for targeted therapies for cancer: a French National Authority for Health statement for health technology assessment. Lancet Oncol 2021; 22:e430-e434. [PMID: 34592192 DOI: 10.1016/s1470-2045(21)00337-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Abstract
During the past decade, health technology assessment bodies have faced new challenges in establishing the benefits of new drugs for individuals and health-care systems. A topic of increasing importance to the field of oncology is the so-called agnostic regulatory approval of targeted therapies for cancer (independent of tumour location and histology) granted on the basis of basket trials. Basket trials in oncology offer the advantage of simultaneously evaluating treatments for multiple tumours, even rare cancers, in a single clinical trial. To address the novel challenges introduced by these trials, an interdisciplinary panel was convened on behalf of the Transparency Committee of the French National Authority for Health to clarify an approach designed to guarantee a transparent, reproducible, and fair assessment of histology-agnostic treatments for reimbursement by the French National Health Insurance Fund. The requirements of this approach include the need for randomisation, clinically relevant endpoints, appropriate correction for multiple significance testing, characterisation of subgroup heterogeneity, and validation of underlying biomarker assays. A prospectively designated external control is encouraged when the implementation of a direct comparison is deemed infeasible. We also underline the importance of recording outcomes from basket trials in a registry for use as future external controls.
Collapse
Affiliation(s)
| | - Julien Peron
- Medical Oncology Department, Cancer Institute of the Hospices Civils of Lyon, Lyon, France
| | - Antoine Vanier
- Unit of Methodology Biostatistics and Data Management, INSERM CIC1415, University Hospital of Tours, Tours, France
| | - François Gueyffier
- UMR 5558 CNRS Lyon, Claude Bernard University Lyon 1, Lyon, France; Public Health Department, Lyon University Hospitals, Lyon, France
| | - Serge Kouzan
- Pulmonary Department, Centre Regional Hospital, Chambery, France
| | - Patrick Dufour
- Medical and Surgical Division of Digestive Pathology, Hautepierre Hospital, Louis Pasteur University, Strasbourg, France
| | - Bernard Guillot
- Dermatology Department, Saint Eloi University Hospital, Montpellier, France
| | - Hugues Blondon
- Department of Gastroenterology and Hepatology, Versailles Hospital, Le Chesnay, France
| | - Michel Clanet
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Pierre Cochat
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Françoise Degos
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Sylvie Chevret
- Biostatistics Department, Saint-Louis Hospital, Paris, France
| | - Mathilde Grande
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Jade Putzolu
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France.
| | | |
Collapse
|
3
|
Sorigue M, Kuittinen O. Robustness and pragmatism of the evidence supporting the European Society for Medical Oncology guidelines for the diagnosis, treatment, and follow-up of follicular lymphoma. Expert Rev Hematol 2021; 14:655-668. [PMID: 34128764 DOI: 10.1080/17474086.2021.1943351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Results of randomized clinical trials may not be entirely applicable to clinical practice. The present manuscript aims to explore the pragmatism and robustness of the evidence that supports the European Society for Medical Oncology (ESMO) follicular lymphoma (FL) guidelines.Methods & design: Analysis of all trials used to support positive, therapeutic, oncological recommendations in the 2020 ESMO FL guidelines. Predefined data points were extracted from each trial. Pragmatism was assessed by means of the PRECIS-2 tool, the difference in overall survival in the interventions compared and the source of funding. Robustness was assessed by means of the fragility index and the p value.Results: 28 trials were included. The full protocol or a protocol summary was provided for 12 (43%). Based on the PRECIS-2 domains, trials were considered pragmatic in organization, analysis and flexibility and explanatory in eligibility. Robustness was high, with 4/24 (17%) trials with p values between 0.05 and 0.005 and a median fragility index of 18.Conclusions: Results of trials to support ESMO recommendations in FL were robust. Pragmatism was high in some domains but modest to low in others and the pattern was similar across trials. Transparency in the publication of trial protocols was suboptimal.
Collapse
Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-IJC-Hospital Germans Trias I Pujol, LUMN, UAB, Badalona, Spain
| | - Outi Kuittinen
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu; Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland & Department of Oncology, Kuopio University Hospital, Kuopio, Finland
| |
Collapse
|