AIM: To review the defnition and performance of the commonly used end points in trials of systemic thera-pies in metastatic castration-resistant prostate cancer patients. METHODS: A literature search was undertaken...AIM: To review the defnition and performance of the commonly used end points in trials of systemic thera-pies in metastatic castration-resistant prostate cancer patients. METHODS: A literature search was undertaken on PubMed database to identify studies meeting estab-lished criteria, with the aim of selecting randomized clinical trials and study definition and performance of their end points. The end points were grouped into three categories: overall survival (OS), time-to-event end points, and response end points. A special analysis was performed for secondary end points of the studies which documented a beneft in OS in the experimental arm. Finally, publishes analyses for surrogacy of the in-cluded end points were also reported. RESULTS: OS, time-to-event and response end points in 31 selected trials were analyzed. OS was the pri-mary end point in 14 trials, and the secondary end point in 17. A time-to-event end point was the primaryend point in 8 studies, and the secondary end point in 22; the most reported time-to-event end points were composite end points, and the events changed among trials. A response end point was the primary end point in 9 studies, in 3 it was prostate-specifc antigen (PSA)-related, in 3 pain-related and in 3 mixed. A response end point was the secondary end point in 19 studies: PSA response and radiologic response were the most frequently used secondary end points in 19 and 11 tri-als, respectively, while pain response was used in 5 studies.CONCLUSION: A homogeneous defnition of progres-sion in future trials is mandatory. Among response end points, pain-response and PSA-response appear to be the most reliable.展开更多
文摘AIM: To review the defnition and performance of the commonly used end points in trials of systemic thera-pies in metastatic castration-resistant prostate cancer patients. METHODS: A literature search was undertaken on PubMed database to identify studies meeting estab-lished criteria, with the aim of selecting randomized clinical trials and study definition and performance of their end points. The end points were grouped into three categories: overall survival (OS), time-to-event end points, and response end points. A special analysis was performed for secondary end points of the studies which documented a beneft in OS in the experimental arm. Finally, publishes analyses for surrogacy of the in-cluded end points were also reported. RESULTS: OS, time-to-event and response end points in 31 selected trials were analyzed. OS was the pri-mary end point in 14 trials, and the secondary end point in 17. A time-to-event end point was the primaryend point in 8 studies, and the secondary end point in 22; the most reported time-to-event end points were composite end points, and the events changed among trials. A response end point was the primary end point in 9 studies, in 3 it was prostate-specifc antigen (PSA)-related, in 3 pain-related and in 3 mixed. A response end point was the secondary end point in 19 studies: PSA response and radiologic response were the most frequently used secondary end points in 19 and 11 tri-als, respectively, while pain response was used in 5 studies.CONCLUSION: A homogeneous defnition of progres-sion in future trials is mandatory. Among response end points, pain-response and PSA-response appear to be the most reliable.