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Are Quality of Randomized Clinical Trials and ESMO-Magnitude of Clinical Benefit Scale Two Sides of the Same Coin to Grade Recommendations for Drug Approval?

机译:是随机临床试验的质量和临床益处的ESMO级别标志着同一枚硬币的两侧以评估药物批准的建议吗?

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摘要

The approval of a new drug for cancer treatment by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) is based on positive, well-designed randomized phase III clinical trials (RCTs). However, not all of them are analyzed to support the recommendations. For this reason, there are different scales to quantify and evaluate the quality of RCTs and the magnitude of the clinical benefits of new drugs for treating solid tumors. In this review, we discuss the value of the progression-free survival (PFS) as an endpoint in RCTs and the concordance between it and the overall survival (OS) as a measure of the quality of clinical trial designs. We summarize and analyze the different scales to evaluate the clinical benefits of new drugs such as the The American Society of Clinical Oncology value framework (ASCO-VF-NHB16) and European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) and the concordance between them, focusing on metastatic colorectal cancer (mCRC). We propose several definitions that would help to evaluate the quality of RCT, the magnitude of clinical benefit and the appropriate approval of new drugs in oncology.
机译:美国食品和药物管理局(FDA)和欧洲药物局(EMA)对癌症治疗的新药物批准是基于阳性,精心设计的随机期III临床试验(RCT)。但是,并非所有这些都被分析以支持提出的建议。因此,存在不同的尺度来量化和评估RCT的质量以及新药治疗实体肿瘤的新药物的临床益处的大小。在本文中,我们将进展的生存(PFS)作为RCT中的终点的价值以及其在临床试验设计质量的衡量标准中的终点和整体生存(OS)。我们总结并分析了不同规模,以评估新药的临床益处,如美国临床肿瘤学会框架(ASCO-VF-NHB16)和欧洲医学肿瘤学科(ESMO-MCB)和欧洲医学肿瘤学会它们之间的一致性,专注于转移性结肠直肠癌(MCRC)。我们提出了有助于评估RCT质量,临床效益的质量和肿瘤中新药物的适当批准的若干定义。

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