Stopping a trial early in oncology: For patients or for industry?

F. Trotta, G. Apolone, S. Garattini, G. Tafuri

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this study is to assess the use of interim analyses in randomised controlled trials (RCTs) testing new anticancer drugs, focussing on oncological clinical trials stopped early for benefit. Materials and methods: All published clinical trials stopped early for benefit and published in the last 11 years, regarding anticancer drugs and containing an interim analysis, were assessed. Results: Twenty-five RCTs were analysed. The evaluation of efficacy was protocol planned through time-related primary end points, >40% of them overall survival. In 95% of studies, at the interim analysis, efficacy was evaluated using the same end point as planned for the final analysis. As a consequence of early stopping after the interim analysis, ∼3300 patients/events across all studies were spared. More than 78% of the RCTs published in the last 3 years were used for registration purposes. Conclusion: Though criticism of the poor quality of oncological trials seems out of place, unfortunately early termination raises new concerns. The relation between sparing patients and saving time and trial costs indicates that there is a market-driven intent. We believe that only untruncated trials can provide a full level of evidence which can be translated into clinical practice without further confirmative trials.

Original languageEnglish
Pages (from-to)1347-1353
Number of pages7
JournalAnnals of Oncology
Volume19
Issue number7
DOIs
Publication statusPublished - Jul 2008

Keywords

  • Anticancer drugs
  • EMEA
  • End point
  • FDA
  • Interim analysis
  • RCT

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Stopping a trial early in oncology: For patients or for industry?'. Together they form a unique fingerprint.

Cite this