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Gourgou-Bourgade S, Cameron D, Poortmans P, Asselain B, Azria D, Cardoso F, A'Hern R, Bliss J, Bogaerts J, Bonnefoi H, Brain E, Cardoso MJ, Chibaudel B, Coleman R, Cufer T, Dal Lago L, Dalenc F, De Azambuja E, Debled M, Delaloge S, Filleron T, Gligorov J, Gutowski M, Jacot W, Kirkove C, MacGrogan G, Michiels S, Negreiros I, Offersen BV, Penault Llorca F, Pruneri G, Roche H, Russell NS, Schmitt F, Servent V, Thürlimann B, Untch M, van der Hage JA, van Tienhoven G, Wildiers H, Yarnold J, Bonnetain F, Mathoulin-Pélissier S, Bellera C, Dabakuyo-Yonli TS. Guidelines for time-to-event end point definitions in breast cancer trials: results of the DATECAN initiative (Definition for the Assessment of Time-to-event Endpoints in CANcer trials)†. Ann Oncol 2015; 26:873-879. [PMID: 25725046 DOI: 10.1093/annonc/mdv106] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 02/16/2015] [Indexed: 02/11/2024] Open
Abstract
BACKGROUND Using surrogate end points for overall survival, such as disease-free survival, is increasingly common in randomized controlled trials. However, the definitions of several of these time-to-event (TTE) end points are imprecisely which limits interpretation and cross-trial comparisons. The estimation of treatment effects may be directly affected by the definitions of end points. The DATECAN initiative (Definition for the Assessment of Time-to-event Endpoints in CANcer trials) aims to provide recommendations for definitions of TTE end points. We report guidelines for randomized cancer clinical trials (RCTs) in breast cancer. PATIENTS AND METHODS A literature review was carried out to identify TTE end points (primary or secondary) reported in publications of randomized trials or guidelines. An international multidisciplinary panel of experts proposed recommendations for the definitions of these end points based on a validated consensus method that formalize the degree of agreement among experts. RESULTS Recommended guidelines for the definitions of TTE end points commonly used in RCTs for breast cancer are provided for non-metastatic and metastatic settings. CONCLUSION The use of standardized definitions should facilitate comparisons of trial results and improve the quality of trial design and reporting. These guidelines could be of particular interest to those involved in the design, conducting, reporting, or assessment of RCT.
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Affiliation(s)
- S Gourgou-Bourgade
- Biostatistic Unit, Montpellier Cancer Institute, Montpellier; Data Center for Cancer Clinical Trials, CTD-INCa, Montpellier, France.
| | - D Cameron
- Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - P Poortmans
- Department of Radiation Oncology, Institute Verbeeten, Tilburg, The Netherlands
| | - B Asselain
- Department of Biostatistics, Institut Curie, Paris
| | - D Azria
- Department of Radiation Oncology, Montpellier Cancer Institute, Montpellier, France
| | - F Cardoso
- Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal
| | - R A'Hern
- Institute of Cancer Research, London, UK
| | - J Bliss
- Institute of Cancer Research, London, UK
| | - J Bogaerts
- EORTC Data Center (European Organization of Research and Treatment of Cancer - Statistics Department), Brussels, Belgium
| | - H Bonnefoi
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux
| | - E Brain
- Departments of Clinical Research and Medical Oncology, Institut Curie - Hôpital René Huguenin, Saint-Cloud
| | - M J Cardoso
- Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal
| | - B Chibaudel
- Department of Medical Oncology, Hôpital Saint-Antoine, Paris, France
| | - R Coleman
- FRCP, FRCPE YCR National Institute for Health Research Cancer Research Network (NCRN), Academic Unit of Clinical Oncology, Weston Park Hospital, Sheffield Cancer Research Centre, Sheffield, UK
| | - T Cufer
- University Clinic Golnik, Golnik, Slovenia
| | - L Dal Lago
- Institut Jules Bordet, University 'Libre' of Brussels, Brussels, Belgium
| | - F Dalenc
- Institut Claudius Régaud, Toulouse
| | - E De Azambuja
- Institut Jules Bordet, University 'Libre' of Brussels, Brussels, Belgium
| | - M Debled
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux
| | - S Delaloge
- Breast Cancer Group, Gustave Roussy Institute, Villejuif
| | | | - J Gligorov
- APHP Tenon - University Cancer Institute - Pierre & Marie Curie, Sorbonne University, Paris
| | | | - W Jacot
- Department of Medical Oncology, Montpellier Cancer Institute, Montpellier, France
| | - C Kirkove
- Université catholique Louvain, Louvain-la-Neuve, Belgium
| | - G MacGrogan
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux
| | - S Michiels
- Biostatistic and Epidemiology Unit, Gustave Roussy, Villejuif; University of Paris-Sud, Villejuif, France
| | - I Negreiros
- Breast Unit, Hospital CUF Descobertas, Lisbon, Portugal
| | - B V Offersen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - F Penault Llorca
- Centre Jean Perrin, Clermont-Ferrand; ERTICA EA4677, UFR Medicine, University of Clermont-Ferrand 1, Clermont-Ferrand, France
| | - G Pruneri
- European Institute of Oncology, Milan; University of Milan, School of Medicine, Milan, Italy
| | - H Roche
- Institut Claudius Régaud, Toulouse
| | - N S Russell
- Department of Radiotherapy, The Netherlands Cancer Institute - Antoni van Leeuwnhoek Hospital, Amsterdam, The Netherlands
| | - F Schmitt
- IPATIMUP (Institute of Molecular Pathology and Immunology of the University of Porto), Porto; Medical Faculty of Porto University, Porto, Portugal
| | - V Servent
- Oscar Lambret Comprehensive Cancer Center, Lille, France
| | - B Thürlimann
- Kantonsspital St Gallen, Breast Center, St Gallen, Switzerland
| | - M Untch
- Clinic for Gynecology, Gynecologic Oncology and Obstetrics-Interdisciplinary Breast Cancer Center, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - J A van der Hage
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam
| | - G van Tienhoven
- Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven; Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, Leuven, Belgium
| | - J Yarnold
- The Institute of Cancer Research, Royal Cancer Hospital, London, UK
| | - F Bonnetain
- Methodological and Quality of Life Unit in Oncology (EA3181), CHU Besançon, Besançon
| | - S Mathoulin-Pélissier
- Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux; Clinical Epidemiology Unit, INSERM CIC 14.01 (Clinical Epidemiology), Bordeaux
| | - C Bellera
- Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux; Clinical Epidemiology Unit, INSERM CIC 14.01 (Clinical Epidemiology), Bordeaux
| | - T S Dabakuyo-Yonli
- Biostatistics and Quality of Life Unit (EA4184), Centre Georges François Leclerc Comprehensive Cancer Centre, Dijon, France
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Bellera CA, Penel N, Ouali M, Bonvalot S, Casali PG, Nielsen OS, Delannes M, Litière S, Bonnetain F, Dabakuyo TS, Benjamin RS, Blay JY, Bui BN, Collin F, Delaney TF, Duffaud F, Filleron T, Fiore M, Gelderblom H, George S, Grimer R, Grosclaude P, Gronchi A, Haas R, Hohenberger P, Issels R, Italiano A, Jooste V, Krarup-Hansen A, Le Péchoux C, Mussi C, Oberlin O, Patel S, Piperno-Neumann S, Raut C, Ray-Coquard I, Rutkowski P, Schuetze S, Sleijfer S, Stoeckle E, Van Glabbeke M, Woll P, Gourgou-Bourgade S, Mathoulin-Pélissier S. Guidelines for time-to-event end point definitions in sarcomas and gastrointestinal stromal tumors (GIST) trials: results of the DATECAN initiative (Definition for the Assessment of Time-to-event Endpoints in CANcer trials)†. Ann Oncol 2014; 26:865-872. [PMID: 25070543 DOI: 10.1093/annonc/mdu360] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 07/23/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The use of potential surrogate end points for overall survival, such as disease-free survival (DFS) or time-to-treatment failure (TTF) is increasingly common in randomized controlled trials (RCTs) in cancer. However, the definition of time-to-event (TTE) end points is rarely precise and lacks uniformity across trials. End point definition can impact trial results by affecting estimation of treatment effect and statistical power. The DATECAN initiative (Definition for the Assessment of Time-to-event End points in CANcer trials) aims to provide recommendations for definitions of TTE end points. We report guidelines for RCT in sarcomas and gastrointestinal stromal tumors (GIST). METHODS We first carried out a literature review to identify TTE end points (primary or secondary) reported in publications of RCT. An international multidisciplinary panel of experts proposed recommendations for the definitions of these end points. Recommendations were developed through a validated consensus method formalizing the degree of agreement among experts. RESULTS Recommended guidelines for the definition of TTE end points commonly used in RCT for sarcomas and GIST are provided for adjuvant and metastatic settings, including DFS, TTF, time to progression and others. CONCLUSION Use of standardized definitions should facilitate comparison of trials' results, and improve the quality of trial design and reporting. These guidelines could be of particular interest to research scientists involved in the design, conduct, reporting or assessment of RCT such as investigators, statisticians, reviewers, editors or regulatory authorities.
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Affiliation(s)
- C A Bellera
- Clinical and Epidemiological Research Unit, Institut Bergonie, Comprehensive Cancer Centre, Bordeaux; Clinical Epidemiology Unit, INSERM CIC 14.01 (Clinical Epidemiology), Bordeaux.
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Comprehensive Cancer Centre, Lille, France
| | - M Ouali
- Department of Biostatistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium; Biostatistics Unit, Institut Claudius Regaud, Comprehensive Cancer Centre, Toulouse
| | - S Bonvalot
- Department of Surgery, Institut Gustave Roussy, Comprehensive Cancer Centre, Villejuif, France
| | - P G Casali
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - O S Nielsen
- Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - M Delannes
- Department of Radiotherapy, Institut Claudius Régaud, Comprehensive Cancer Center, Toulouse
| | - S Litière
- Department of Biostatistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - F Bonnetain
- Methodological and Quality of Life Unit in Oncology (EA3181), CHU Besançon, Besançon
| | - T S Dabakuyo
- Biostatistics and Quality of Life Unit (EA4184), Centre Georges-François Leclerc, Comprehensive Cancer Centre, Dijon, France
| | - R S Benjamin
- Division of Cancer Medicine and Sarcoma Center, The University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - J-Y Blay
- Department of Medical Oncology, Centre Léon Bérard, Comprehensive Cancer Centre, Lyon; Claude Bernard Lyon I University, Lyon; Medical Oncology Unit, Edouard Herriot Hospital, Lyon
| | - B N Bui
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux
| | - F Collin
- Department of Biology and Pathology, Centre Georges-François Leclerc, Comprehensive Cancer Centre, Dijon, France
| | - T F Delaney
- Department of Radiation Oncology and Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, USA
| | - F Duffaud
- Department of Medical Oncology, La Timone Hospital University, Marseille, France
| | - T Filleron
- Biostatistics Unit, Institut Claudius Regaud, Comprehensive Cancer Centre, Toulouse
| | - M Fiore
- Department of Surgery and Sarcoma Unit, Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - H Gelderblom
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - S George
- Department of Medical Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - R Grimer
- Royal Orthopaedic Hospital NHS Trust, Birmingham, UK
| | - P Grosclaude
- Cancer Registry of Tarn, Institut Claudius Regaud, Comprehensive Cancer Centre, Toulouse, France
| | - A Gronchi
- Department of Surgery and Sarcoma Unit, Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Haas
- Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - P Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, Mannheim
| | - R Issels
- Sarcoma Center, Ludwig-Maximilian University Munich, Munich; Department of Internal Medicine, Klinikum Grosshadern Medical Center, University of Munich, Munich, Germany
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux
| | - V Jooste
- Burgundy Digestive Cancer Registry, INSERM U866, University of Burgundy, Dijon, France
| | - A Krarup-Hansen
- Department of Oncology, Herlev Hospital-University Copenhagen, Herlev, Denmark
| | - C Le Péchoux
- Department of Radiotherapy, Institut Gustave Roussy, Comprehensive Cancer Centre, Villejuif, France
| | - C Mussi
- Department of Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - O Oberlin
- Department of Surgery and Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, Comprehensive Cancer Centre, Villejuif
| | - S Patel
- Division of Cancer Medicine and Sarcoma Center, The University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - S Piperno-Neumann
- Department of Medical Oncology, Institut Curie, Comprehensive Cancer Centre, Paris, France
| | - C Raut
- Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - I Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard, Comprehensive Cancer Centre, Lyon
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - S Schuetze
- Department of Medical Oncology, University of Michigan, Ann Arbor, USA
| | - S Sleijfer
- Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | - E Stoeckle
- Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| | - M Van Glabbeke
- Department of Biostatistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - P Woll
- Department of Oncology, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK
| | - S Gourgou-Bourgade
- Montpellier Cancer Institute, Comprehensive Cancer Centre, Montpellier, France
| | - S Mathoulin-Pélissier
- Clinical and Epidemiological Research Unit, Institut Bergonie, Comprehensive Cancer Centre, Bordeaux; Clinical Epidemiology Unit, INSERM CIC 14.01 (Clinical Epidemiology), Bordeaux
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