Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations
Abstract Background Time to deterioration (TTD) endpoints are often utilized in the analysis of patient-reported outcome (PRO) data in oncology clinical trials but different endpoint definitions and analysis frameworks exist that can impact result interpretation. This review examined the analysis, r...
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| Format: | Article |
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SpringerOpen
2024-12-01
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| Series: | Journal of Patient-Reported Outcomes |
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| Online Access: | https://doi.org/10.1186/s41687-024-00824-7 |
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| author | Kim Cocks Bellinda L. King-Kallimanis Joel Sims Gill Worthy Julia Stein Lara Ayala–Nunes Monika Achra Zhanglin Lin Cui Nalin Payakachat |
| author_facet | Kim Cocks Bellinda L. King-Kallimanis Joel Sims Gill Worthy Julia Stein Lara Ayala–Nunes Monika Achra Zhanglin Lin Cui Nalin Payakachat |
| author_sort | Kim Cocks |
| collection | DOAJ |
| description | Abstract Background Time to deterioration (TTD) endpoints are often utilized in the analysis of patient-reported outcome (PRO) data in oncology clinical trials but different endpoint definitions and analysis frameworks exist that can impact result interpretation. This review examined the analysis, reporting and heterogeneity of TTD endpoints in the literature, the impact of analysis methods on results, and provides recommendations for future trials. Methods A targeted literature review of articles published between 2017 and 2022 was performed to collate TTD endpoints reported in oncology randomized controlled trials (RCTs). Details of endpoints and results were extracted including; deterioration definition, PRO assessment schedule, methods for handling intercurrent events, statistical analysis methods, main trial results (overall survival and/or progression-free survival) and TTD endpoint results. Results Seventy RCTs were included covering 849 individual TTD endpoints. There were 17 primary cancer types, with lung (26%), breast (11%), and prostate (7%) cancers the most common. Most trials (71%) were for people with advanced cancer. Full definitions of TTD endpoints were often missing. There were no clear trends for a specific TTD definition within cancer types or stages. However, statistical analysis methods were consistent among trials. Conclusion The TTD definition can vary and is ultimately driven by the research question. Points to consider for successfully implementing PRO TTD endpoints in oncology include consideration of the trial setting (e.g., early vs. advanced cancer), expected treatment effect (e.g., improvement vs. worsening), likely adverse event profile (including early vs. delayed) and PRO data collection frequency in order to improve utility of these endpoints. |
| format | Article |
| id | doaj-art-b22f7ff585eb40a98ea8365b0e4dc34d |
| institution | Kabale University |
| issn | 2509-8020 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Patient-Reported Outcomes |
| spelling | doaj-art-b22f7ff585eb40a98ea8365b0e4dc34d2024-12-22T12:29:01ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202024-12-018111410.1186/s41687-024-00824-7Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendationsKim Cocks0Bellinda L. King-Kallimanis1Joel Sims2Gill Worthy3Julia Stein4Lara Ayala–Nunes5Monika Achra6Zhanglin Lin Cui7Nalin Payakachat8Adelphi Values Ltd, Patient-Centered OutcomesLUNGevity FoundationAdelphi Values Ltd, Patient-Centered OutcomesAdelphi Values Ltd, Patient-Centered OutcomesAdelphi Values Ltd, Patient-Centered OutcomesAdelphi Values Ltd, Patient-Centered OutcomesEli Lilly and CompanyEli Lilly and CompanyEli Lilly and CompanyAbstract Background Time to deterioration (TTD) endpoints are often utilized in the analysis of patient-reported outcome (PRO) data in oncology clinical trials but different endpoint definitions and analysis frameworks exist that can impact result interpretation. This review examined the analysis, reporting and heterogeneity of TTD endpoints in the literature, the impact of analysis methods on results, and provides recommendations for future trials. Methods A targeted literature review of articles published between 2017 and 2022 was performed to collate TTD endpoints reported in oncology randomized controlled trials (RCTs). Details of endpoints and results were extracted including; deterioration definition, PRO assessment schedule, methods for handling intercurrent events, statistical analysis methods, main trial results (overall survival and/or progression-free survival) and TTD endpoint results. Results Seventy RCTs were included covering 849 individual TTD endpoints. There were 17 primary cancer types, with lung (26%), breast (11%), and prostate (7%) cancers the most common. Most trials (71%) were for people with advanced cancer. Full definitions of TTD endpoints were often missing. There were no clear trends for a specific TTD definition within cancer types or stages. However, statistical analysis methods were consistent among trials. Conclusion The TTD definition can vary and is ultimately driven by the research question. Points to consider for successfully implementing PRO TTD endpoints in oncology include consideration of the trial setting (e.g., early vs. advanced cancer), expected treatment effect (e.g., improvement vs. worsening), likely adverse event profile (including early vs. delayed) and PRO data collection frequency in order to improve utility of these endpoints.https://doi.org/10.1186/s41687-024-00824-7Patient reported outcomeNeoplasmsEndpoint determinationSurvival analysisRandomized controlled trialsReview literature |
| spellingShingle | Kim Cocks Bellinda L. King-Kallimanis Joel Sims Gill Worthy Julia Stein Lara Ayala–Nunes Monika Achra Zhanglin Lin Cui Nalin Payakachat Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations Journal of Patient-Reported Outcomes Patient reported outcome Neoplasms Endpoint determination Survival analysis Randomized controlled trials Review literature |
| title | Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations |
| title_full | Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations |
| title_fullStr | Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations |
| title_full_unstemmed | Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations |
| title_short | Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations |
| title_sort | time to deterioration of patient reported outcome endpoints in cancer clinical trials targeted literature review and best practice recommendations |
| topic | Patient reported outcome Neoplasms Endpoint determination Survival analysis Randomized controlled trials Review literature |
| url | https://doi.org/10.1186/s41687-024-00824-7 |
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