抗癌药物临床疗效评价标准

A. V. Tikhomirova
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引用次数: 1

摘要

临床疗效评价标准使评估患者接受的抗癌药物的风险-效益比成为可能,特别是用于治疗实体恶性肿瘤。一种药物的疗效是用称为临床疗效终点的特殊标准来评估的,这允许对研究结果进行最客观的评估。研究表明,目前抗癌药物的临床疗效是使用“以患者为中心”(总生存期和生活质量)和“以肿瘤为中心”(治疗反应、无进展生存期、无疾病生存期)终点来评估的。“以患者为中心”的终点使得评估化疗对患者的直接临床获益成为可能,而“以肿瘤为中心”的终点允许在早期阶段评估疗效,而不直接反映临床获益。对最合适的终点进行分析,目的是使其与主要结局指标(总生存期)可互换,这在肿瘤学中变得越来越重要。疗效标准的选择应考虑到特定肿瘤疾病的具体特征、研究人群和治疗时间。该研究的作者分析了包含抗癌药物疗效标准信息的俄罗斯和外国文献来源,并强调了这些标准的优点和缺点。研究表明,临床终点应具有临床意义,对治疗敏感,易于测量和解释。结果指标的综合评价可以充分评估抗癌药物的风险-收益比。
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Criteria for Evaluation of Clinical Efficacy of Anticancer Medicines
Criteria for evaluation of clinical efficacy make it possible to assess the risk-benefit ratio of anticancer medicines that patients receive, in particular, for the treatment of solid malignant tumors. A medicine’s efficacy is assessed using special criteria called the endpoints of clinical efficacy, allowing most objective assessment of study results. It was demonstrated that nowadays clinical efficacy of anticancer drugs is assessed using «patient-centered» (overall survival and quality of life) and «tumor-centered» (response to therapy, progression-free survival, disease-free survival) endpoints. «Patient-centered» endpoints make it possible to evaluate the direct clinical benefit of chemotherapy in patients, while «tumor-centered» endpoints allow for evaluation of efficacy at earlier stages, without directly reflecting the clinical benefit. The analysis of the most suitable endpoints with the aim of making them interchangeable with the primary outcome measure – overall survival – is becoming more and more relevant in oncology. The choice of criteria of efficacy should be made taking into account the specific features of a particular oncological disease, study population and duration of therapy. The authors of the study analysed Russian and foreign literary sources containing information on criteria of efficacy of anticancer medicines and highlighted the advantages and disadvantages of these criteria. The study showed that clinical endpoints should be clinically significant, sensitive to therapy, easy to measure and interpret. It was demonstrated that comprehensive evaluation of outcome measures makes it possible to adequately assess the risk-benefit ratio of anticancer medicines.
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