Re-inventing the randomized controlled trial in medical oncology: The registry-based trial

Foroughi, S; Wong, HL; Gately, L; Lee, M; Simons, K; Tie, J; Burgess, AW; Gibbs, P

Author(s): Foroughi, S; Wong, HL; Gately, L; Lee, M; Simons, K; Tie, J; Burgess, AW; Gibbs, P;
Details: Publication Year 2018-12,Volume 14,Issue #6,Page 365-373
Journal Title: Asia Pacific Journal of Clinical Oncology
Publication Type: Journal Article
Abstract: Substantial progress has recently been made in optimizing the management of cancer patients, resulting in major gains in survival and quality of life. Much of this progress has resulted from the serial testing of promising treatment strategies, typically using prospective randomized controlled trials to compare outcomes achieved with the new approach versus the current standard(s) of care. However, there is an ever-expanding list of important questions that are difficult to investigate, particularly with respect to determining the optimal sequencing and combination of proven active agents. With the rapidly growing list of clinical, pathologic and molecular characteristics that promise to predict treatment benefit and/or risk for defined patient subsets, many new questions regarding how best to personalize our approach to treatment selection are emerging. These questions can be investigated in the context of registry-based randomized clinical trials. Recently, the potential of registry-based randomized clinical trials was demonstrated in cardiology, highlighting the ability to rapidly recruit large numbers of patients to a trial addressing an important clinical question, with minimal cost and high external validity. In this review, we discuss the challenges and limitations of conventional clinical trials in multidisciplinary cancer care, describe the potential advantages of registry-based randomized trials, and highlight several registry-based oncology studies that are already underway to demonstrate the feasibility of this approach.
Publisher: Wiley
Research Division(s): Systems Biology And Personalised Medicine; Structural Biology
PubMed ID: 29947051
Publisher's Version: https://doi.org/10.1111/ajco.12992
Open Access at Publisher's Site: https://doi.org/10.1111/ajco.12992
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2018-07-09 02:45:04

Last Modified: 2019-01-09 02:56:45