Delgado Amanda, Guddati Achuta Kumar
Division of Hematology/Oncology, Georgia Cancer Center, Augusta University GA 30912, Augusta.
Am J Cancer Res. 2021 Apr 15;11(4):1121-1131. eCollection 2021.
Clinical endpoints are essential for assessing the safety and efficacy of new cancer therapies. They are used by oncologists to help guide clinical decision making. While overall survival (OS) has frequently been regarded as the "gold standard" primary clinical endpoint, it's utility is constrained by several disadvantages. The time-consuming nature of trials using OS has led to a recent push to explore surrogate clinical endpoints and their potential to serve as primary clinical endpoints in lieu of OS. Additionally, it is becoming evident that other endpoints add valuable information about quality of life and treatment failure as their use is becoming increasingly prevalent in oncology clinical trials. Without a doubt, the use of clinical endpoints will continue to expand and evolve as new cancer therapies are developed and novel treatments, including immunotherapy, draw interest. This review explores the roles of primary and surrogate clinical endpoints as well as the benefits and drawbacks of each specific endpoint. In addition, it directly compares the unique features of each suggesting some of the specific uses each one fulfills.
临床终点对于评估新型癌症疗法的安全性和有效性至关重要。肿瘤学家利用它们来帮助指导临床决策。虽然总生存期(OS)常常被视为“金标准”主要临床终点,但其效用受到若干不利因素的限制。使用总生存期进行试验耗时较长,这促使人们最近开始探索替代临床终点以及它们替代总生存期作为主要临床终点的潜力。此外,越来越明显的是,其他终点提供了有关生活质量和治疗失败的有价值信息,因为它们在肿瘤学临床试验中的应用越来越普遍。毫无疑问,随着新型癌症疗法的开发以及包括免疫疗法在内的新型治疗方法引发关注,临床终点的使用将继续扩展和演变。本综述探讨了主要和替代临床终点的作用以及每个特定终点的优缺点。此外,它直接比较了每个终点的独特特征,指出了每个终点所满足的一些具体用途。