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Smaller, faster trials can improve cancer patient survival
Date:9/25/2011

Stockholm, Sweden: With the advent of personalised medicine, gains in cancer survival over the long term could be improved by running smaller, faster trials with less stringent evidence criteria, a researcher told the 2011 European Multidisciplinary Cancer Congress [1] today (Monday 26 Sept).

The introduction of targeted treatments means the traditional large-scale clinical trial is not always the most effective way of getting new treatments to cancer patients who need them, said Dr. Marie-Ccile Le Deley, Associate Professor of Clinical Epidemiology and Biostatistics at the Institut Gustave-Roussy, Villejuif, France. The increased knowledge of tumour biology has meant that common cancers are more and more frequently recognised as consisting of small subsets with particular abnormalities. These abnormalities might be targeted by specific therapies, but the ability to test many of the promising agents available is hindered by the need to invest many resources into running a single large trial over many years, she said.

Working with colleagues at The Mayo Clinic in Rochester, Minnesota, USA, Dr. Le Deley simulated a series of two-treatment superiority trials (where a new treatment is compared with the existing standard therapy), taking place over 15 years and using different design parameters. These included the number of trials performed during the period, and the criteria used to adopt an experimental treatment as the new standard. The researchers used these studies to estimate, for different strategies, the survival improvements that could be expected over a 15-year research period.

"We found that there were important gains in survival attributable to a strategy of conducting more trials with smaller sample sizes and relaxed evidential criteria compared with those required under traditional trial designs," said Dr. Le Deley. "The downside of this approach is that we also reduce the certainty of the findings: we might select as a new t
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Contact: Mary Rice
mary.rice@riceconseil.eu
ECCO-the European CanCer Organisation
Source:Eurekalert

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