C A Bellera1, N Penel2, M Ouali3, S Bonvalot4, P G Casali5, O S Nielsen6, M Delannes7, S Litière8, F Bonnetain9, T S Dabakuyo10, R S Benjamin11, J-Y Blay12, B N Bui13, F Collin14, T F Delaney15, F Duffaud16, T Filleron17, M Fiore18, H Gelderblom19, S George20, R Grimer21, P Grosclaude22, A Gronchi18, R Haas23, P Hohenberger24, R Issels25, A Italiano13, V Jooste26, A Krarup-Hansen27, C Le Péchoux28, C Mussi29, O Oberlin30, S Patel11, S Piperno-Neumann31, C Raut32, I Ray-Coquard33, P Rutkowski34, S Schuetze35, S Sleijfer36, E Stoeckle37, M Van Glabbeke8, P Woll38, S Gourgou-Bourgade39, S Mathoulin-Pélissier40. 1. Clinical and Epidemiological Research Unit, Institut Bergonie, Comprehensive Cancer Centre, Bordeaux Clinical Epidemiology Unit, INSERM CIC 14.01 (Clinical Epidemiology), Bordeaux c.bellera@bordeaux.unicancer.fr. 2. Department of Medical Oncology, Centre Oscar Lambret, Comprehensive Cancer Centre, Lille, France. 3. Department of Biostatistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium Biostatistics Unit, Institut Claudius Regaud, Comprehensive Cancer Centre, Toulouse. 4. Department of Surgery, Institut Gustave Roussy, Comprehensive Cancer Centre, Villejuif, France. 5. Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 6. Faculty of Health Sciences, Aarhus University, Aarhus, Denmark. 7. Department of Radiotherapy, Institut Claudius Régaud, Comprehensive Cancer Center, Toulouse. 8. Department of Biostatistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium. 9. Methodological and Quality of Life Unit in Oncology (EA3181), CHU Besançon, Besançon. 10. Biostatistics and Quality of Life Unit (EA4184), Centre Georges-François Leclerc, Comprehensive Cancer Centre, Dijon, France. 11. Division of Cancer Medicine and Sarcoma Center, The University of Texas M.D. Anderson Cancer Center, Houston, USA. 12. Department of Medical Oncology, Centre Léon Bérard, Comprehensive Cancer Centre, Lyon Claude Bernard Lyon I University, Lyon Medical Oncology Unit, Edouard Herriot Hospital, Lyon. 13. Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux. 14. Department of Biology and Pathology, Centre Georges-François Leclerc, Comprehensive Cancer Centre, Dijon, France. 15. Department of Radiation Oncology and Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, USA. 16. Department of Medical Oncology, La Timone Hospital University, Marseille, France. 17. Biostatistics Unit, Institut Claudius Regaud, Comprehensive Cancer Centre, Toulouse. 18. Department of Surgery and Sarcoma Unit, Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 19. Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands. 20. Department of Medical Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA. 21. Royal Orthopaedic Hospital NHS Trust, Birmingham, UK. 22. Cancer Registry of Tarn, Institut Claudius Regaud, Comprehensive Cancer Centre, Toulouse, France. 23. Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 24. Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, Mannheim. 25. Sarcoma Center, Ludwig-Maximilian University Munich, Munich Department of Internal Medicine, Klinikum Grosshadern Medical Center, University of Munich, Munich, Germany. 26. Burgundy Digestive Cancer Registry, INSERM U866, University of Burgundy, Dijon, France. 27. Department of Oncology, Herlev Hospital-University Copenhagen, Herlev, Denmark. 28. Department of Radiotherapy, Institut Gustave Roussy, Comprehensive Cancer Centre, Villejuif, France. 29. Department of Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. 30. Department of Surgery and Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, Comprehensive Cancer Centre, Villejuif. 31. Department of Medical Oncology, Institut Curie, Comprehensive Cancer Centre, Paris, France. 32. Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA. 33. Department of Medical Oncology, Centre Léon Bérard, Comprehensive Cancer Centre, Lyon. 34. Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland. 35. Department of Medical Oncology, University of Michigan, Ann Arbor, USA. 36. Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. 37. Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France. 38. Department of Oncology, Sheffield Cancer Research Centre, Weston Park Hospital, Sheffield, UK. 39. Montpellier Cancer Institute, Comprehensive Cancer Centre, Montpellier, France. 40. Clinical and Epidemiological Research Unit, Institut Bergonie, Comprehensive Cancer Centre, Bordeaux Clinical Epidemiology Unit, INSERM CIC 14.01 (Clinical Epidemiology), Bordeaux.
Abstract
BACKGROUND: The use of potential surrogate end points for overall survival, such as disease-free survival (DFS) or time-to-treatment failure (TTF) is increasingly common in randomized controlled trials (RCTs) in cancer. However, the definition of time-to-event (TTE) end points is rarely precise and lacks uniformity across trials. End point definition can impact trial results by affecting estimation of treatment effect and statistical power. The DATECAN initiative (Definition for the Assessment of Time-to-event End points in CANcer trials) aims to provide recommendations for definitions of TTE end points. We report guidelines for RCT in sarcomas and gastrointestinal stromal tumors (GIST). METHODS: We first carried out a literature review to identify TTE end points (primary or secondary) reported in publications of RCT. An international multidisciplinary panel of experts proposed recommendations for the definitions of these end points. Recommendations were developed through a validated consensus method formalizing the degree of agreement among experts. RESULTS: Recommended guidelines for the definition of TTE end points commonly used in RCT for sarcomas and GIST are provided for adjuvant and metastatic settings, including DFS, TTF, time to progression and others. CONCLUSION: Use of standardized definitions should facilitate comparison of trials' results, and improve the quality of trial design and reporting. These guidelines could be of particular interest to research scientists involved in the design, conduct, reporting or assessment of RCT such as investigators, statisticians, reviewers, editors or regulatory authorities.
BACKGROUND: The use of potential surrogate end points for overall survival, such as disease-free survival (DFS) or time-to-treatment failure (TTF) is increasingly common in randomized controlled trials (RCTs) in cancer. However, the definition of time-to-event (TTE) end points is rarely precise and lacks uniformity across trials. End point definition can impact trial results by affecting estimation of treatment effect and statistical power. The DATECAN initiative (Definition for the Assessment of Time-to-event End points in CANcer trials) aims to provide recommendations for definitions of TTE end points. We report guidelines for RCT in sarcomas and gastrointestinal stromal tumors (GIST). METHODS: We first carried out a literature review to identify TTE end points (primary or secondary) reported in publications of RCT. An international multidisciplinary panel of experts proposed recommendations for the definitions of these end points. Recommendations were developed through a validated consensus method formalizing the degree of agreement among experts. RESULTS: Recommended guidelines for the definition of TTE end points commonly used in RCT for sarcomas and GIST are provided for adjuvant and metastatic settings, including DFS, TTF, time to progression and others. CONCLUSION: Use of standardized definitions should facilitate comparison of trials' results, and improve the quality of trial design and reporting. These guidelines could be of particular interest to research scientists involved in the design, conduct, reporting or assessment of RCT such as investigators, statisticians, reviewers, editors or regulatory authorities.
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