Making progress in early breast cancer: Taking time or accepting risk?
Identifieur interne : 000397 ( Main/Exploration ); précédent : 000396; suivant : 000398Making progress in early breast cancer: Taking time or accepting risk?
Auteurs : Gurdeep S. Mannu [Royaume-Uni] ; David Dodwell [Royaume-Uni]Source :
- European Journal of Cancer [ 0959-8049 ] ; 2017.
Abstract
Outcomes for patients diagnosed with early breast cancer in developed countries have improved substantially over recent decades. Adjuvant therapies have contributed to this improvement and their benefits have been confirmed in large randomised controlled trials (RCTs) and meta-analyses. Lower event rates, whilst welcome, have created problems for RCTs, that need to be larger and often take longer to provide a reliable result. In an effort to maintain the rate of progress and to obviate the complexity, cost and time required to conduct large RCTs, there has been an increased tendency to rely on observational data to determine a treatment effect and also to accelerate progress by the use of a surrogate marker (pathological complete remission after neoadjuvant chemotherapy). We highlight the pitfalls in these approaches and suggest some simplifications in the conduct of RCTs.
Url:
DOI: 10.1016/j.ejca.2017.03.005
PubMed: 28411447
PubMed Central: 5446260
Affiliations:
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Mannu</name><affiliation wicri:level="4"><nlm:aff id="aff1">Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Dodwell, David" sort="Dodwell, David" uniqKey="Dodwell D" first="David" last="Dodwell">David Dodwell</name><affiliation wicri:level="4"><nlm:aff id="aff2">Nuffield Department of Population Health, University of Oxford, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Nuffield Department of Population Health, University of Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author></analytic><series><title level="j">European Journal of Cancer</title><idno type="ISSN">0959-8049</idno><idno type="eISSN">1879-0852</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Outcomes for patients diagnosed with early breast cancer in developed countries have improved substantially over recent decades. Adjuvant therapies have contributed to this improvement and their benefits have been confirmed in large randomised controlled trials (RCTs) and meta-analyses. Lower event rates, whilst welcome, have created problems for RCTs, that need to be larger and often take longer to provide a reliable result. In an effort to maintain the rate of progress and to obviate the complexity, cost and time required to conduct large RCTs, there has been an increased tendency to rely on observational data to determine a treatment effect and also to accelerate progress by the use of a surrogate marker (pathological complete remission after neoadjuvant chemotherapy). We highlight the pitfalls in these approaches and suggest some simplifications in the conduct of RCTs.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Poortmans, P M" uniqKey="Poortmans P">P.M. Poortmans</name></author><author><name sortKey="Collette, S" uniqKey="Collette S">S. Collette</name></author><author><name sortKey="Kirkove, C" uniqKey="Kirkove C">C. Kirkove</name></author><author><name sortKey="Van Limbergen, E" uniqKey="Van Limbergen E">E. Van Limbergen</name></author><author><name sortKey="Budach, V" uniqKey="Budach V">V. Budach</name></author><author><name sortKey="Struikmans, H" uniqKey="Struikmans H">H. Struikmans</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cortazar, P" uniqKey="Cortazar P">P. Cortazar</name></author><author><name sortKey="Zhang, L" uniqKey="Zhang L">L. Zhang</name></author><author><name sortKey="Untch, M" uniqKey="Untch M">M. Untch</name></author><author><name sortKey="Mehta, K" uniqKey="Mehta K">K. Mehta</name></author><author><name sortKey="Costantino, J P" uniqKey="Costantino J">J.P. Costantino</name></author><author><name sortKey="Wolmark, N" uniqKey="Wolmark N">N. Wolmark</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Early Breast Cancer Trialists Collaborative Group Ebctcg" uniqKey="Early Breast Cancer Trialists Collaborative Group Ebctcg">Early Breast Cancer Trialists' Collaborative Group (EBCTCG)</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Purushotham, A" uniqKey="Purushotham A">A. Purushotham</name></author><author><name sortKey="Pinder, S" uniqKey="Pinder S">S. Pinder</name></author><author><name sortKey="Cariati, M" uniqKey="Cariati M">M. Cariati</name></author><author><name sortKey="Harries, M" uniqKey="Harries M">M. Harries</name></author><author><name sortKey="Goldhirsch, A" uniqKey="Goldhirsch A">A. Goldhirsch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Prowell, T M" uniqKey="Prowell T">T.M. Prowell</name></author><author><name sortKey="Pazdur, R" uniqKey="Pazdur R">R. Pazdur</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rose, B S" uniqKey="Rose B">B.S. Rose</name></author><author><name sortKey="Winer, E P" uniqKey="Winer E">E.P. Winer</name></author><author><name sortKey="Mamon, H J" uniqKey="Mamon H">H.J. Mamon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hill, A B" uniqKey="Hill A">A.B. Hill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcgale, P" uniqKey="Mcgale P">P. McGale</name></author><author><name sortKey="Cutter, D" uniqKey="Cutter D">D. Cutter</name></author><author><name sortKey="Darby, S C" uniqKey="Darby S">S.C. Darby</name></author><author><name sortKey="Henson, K E" uniqKey="Henson K">K.E. Henson</name></author><author><name sortKey="Jagsi, R" uniqKey="Jagsi R">R. Jagsi</name></author><author><name sortKey="Taylor, C W" uniqKey="Taylor C">C.W. Taylor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sagara, Y" uniqKey="Sagara Y">Y. Sagara</name></author><author><name sortKey="Freedman, R A" uniqKey="Freedman R">R.A. Freedman</name></author><author><name sortKey="Vaz Luis, I" uniqKey="Vaz Luis I">I. Vaz-Luis</name></author><author><name sortKey="Mallory, M A" uniqKey="Mallory M">M.A. Mallory</name></author><author><name sortKey="Wong, S M" uniqKey="Wong S">S.M. Wong</name></author><author><name sortKey="Aydogan, F" uniqKey="Aydogan F">F. Aydogan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Early Breast Cancer Trialists Collaborative Group Ebctcg" uniqKey="Early Breast Cancer Trialists Collaborative Group Ebctcg">Early Breast Cancer Trialists' Collaborative Group (EBCTCG)</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mello, M M" uniqKey="Mello M">M.M. Mello</name></author><author><name sortKey="Brennan, T A" uniqKey="Brennan T">T.A. Brennan</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Oxfordshire</li></region><settlement><li>Oxford</li></settlement><orgName><li>Université d'Oxford</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mannu, Gurdeep S" sort="Mannu, Gurdeep S" uniqKey="Mannu G" first="Gurdeep S." last="Mannu">Gurdeep S. Mannu</name></region><name sortKey="Dodwell, David" sort="Dodwell, David" uniqKey="Dodwell D" first="David" last="Dodwell">David Dodwell</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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