{"title":"需要就成人急性淋巴细胞白血病试验中的主要终点和疗效定义达成共识。","authors":"Matthew J Wieduwilt","doi":"10.1182/bloodadvances.2023010449","DOIUrl":null,"url":null,"abstract":"<p><strong>Abstract: </strong>The lack of consensus on acceptable primary end points and definitions of response and survival in phase 2/3 efficacy studies for adult acute lymphoblastic leukemia has led to widely different clinical trial designs. Inconsistency in primary end point selection and lack of consensus on response, survival end points, and adequate follow-up time lead to difficulty in interpreting completed studies and developing future trials. The lack of consensus also runs the risk of integrating ineffective or unacceptably toxic regimens into clinical practice and future trials. Increasingly, studies integrating highly active, targeted agents into chemotherapy use short-term end points of response, measurable residual disease-negative response, and early event-free survival without confidence that these end points will translate into improved late patient outcomes. This article highlights the current consequences and dilemmas caused by this lack of consensus. The hope is to stimulate discussion and ultimately consensus to improve the interpretation and application of clinical trial results.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":null,"pages":null},"PeriodicalIF":7.4000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372386/pdf/","citationCount":"0","resultStr":"{\"title\":\"Need for consensus on primary end points and efficacy definitions in trials for adult acute lymphoblastic leukemia.\",\"authors\":\"Matthew J Wieduwilt\",\"doi\":\"10.1182/bloodadvances.2023010449\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Abstract: </strong>The lack of consensus on acceptable primary end points and definitions of response and survival in phase 2/3 efficacy studies for adult acute lymphoblastic leukemia has led to widely different clinical trial designs. Inconsistency in primary end point selection and lack of consensus on response, survival end points, and adequate follow-up time lead to difficulty in interpreting completed studies and developing future trials. The lack of consensus also runs the risk of integrating ineffective or unacceptably toxic regimens into clinical practice and future trials. Increasingly, studies integrating highly active, targeted agents into chemotherapy use short-term end points of response, measurable residual disease-negative response, and early event-free survival without confidence that these end points will translate into improved late patient outcomes. This article highlights the current consequences and dilemmas caused by this lack of consensus. The hope is to stimulate discussion and ultimately consensus to improve the interpretation and application of clinical trial results.</p>\",\"PeriodicalId\":9228,\"journal\":{\"name\":\"Blood advances\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":7.4000,\"publicationDate\":\"2024-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372386/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Blood advances\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1182/bloodadvances.2023010449\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood advances","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1182/bloodadvances.2023010449","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Need for consensus on primary end points and efficacy definitions in trials for adult acute lymphoblastic leukemia.
Abstract: The lack of consensus on acceptable primary end points and definitions of response and survival in phase 2/3 efficacy studies for adult acute lymphoblastic leukemia has led to widely different clinical trial designs. Inconsistency in primary end point selection and lack of consensus on response, survival end points, and adequate follow-up time lead to difficulty in interpreting completed studies and developing future trials. The lack of consensus also runs the risk of integrating ineffective or unacceptably toxic regimens into clinical practice and future trials. Increasingly, studies integrating highly active, targeted agents into chemotherapy use short-term end points of response, measurable residual disease-negative response, and early event-free survival without confidence that these end points will translate into improved late patient outcomes. This article highlights the current consequences and dilemmas caused by this lack of consensus. The hope is to stimulate discussion and ultimately consensus to improve the interpretation and application of clinical trial results.
期刊介绍:
Blood Advances, a semimonthly medical journal published by the American Society of Hematology, marks the first addition to the Blood family in 70 years. This peer-reviewed, online-only, open-access journal was launched under the leadership of founding editor-in-chief Robert Negrin, MD, from Stanford University Medical Center in Stanford, CA, with its inaugural issue released on November 29, 2016.
Blood Advances serves as an international platform for original articles detailing basic laboratory, translational, and clinical investigations in hematology. The journal comprehensively covers all aspects of hematology, including disorders of leukocytes (both benign and malignant), erythrocytes, platelets, hemostatic mechanisms, vascular biology, immunology, and hematologic oncology. Each article undergoes a rigorous peer-review process, with selection based on the originality of the findings, the high quality of the work presented, and the clarity of the presentation.