Missing tumor measurement (TM) data in the search for alternative TM-based endpoints in cancer clinical trials

Bibliographic Details
Title: Missing tumor measurement (TM) data in the search for alternative TM-based endpoints in cancer clinical trials
Authors: Ming-Wen An, Jun Tang, Axel Grothey, Daniel J. Sargent, Fang-Shu Ou, Sumithra J. Mandrekar
Source: Contemporary Clinical Trials Communications, Vol 17, Iss , Pp - (2020)
Publisher Information: Elsevier, 2020.
Publication Year: 2020
Collection: LCC:Medicine (General)
Subject Terms: Medicine (General), R5-920
More Details: Purpose: Missing data commonly occur in cancer clinical trials (CCT) and may hinder the search for alternative trial endpoints. We consider reasons for missing tumor measurement (TM) data in CCT and how missing TM data are typically handled. We explore the potential impact of missing TM data on predictive ability of a set of TM-based endpoints. Methods: Literature review identifies reasons for and approaches to handling missing TM data. Data from 3 actual clinical trials were used for illustration. A sensitivity analysis of the potential impact of missing TM data was performed by comparing overall survival (OS) predictive ability of alternative endpoints using observed and imputed data. Results: Reasons for missing TM data in CCT are presented, based on the literature review and the three trials. Although missing TM data impacted individual objective status (e.g. 12-week status changed for 53% of patients in one imputation set), it surprisingly only minimally impacted endpoint predictive ability (e.g. median c-indices of 500 imputed datasets ranged from 0.566 to 0.570 for N9741, 0.592–0.616 for N9841, and 0.542–0.624 for N0026). Conclusion: By understanding the reasons for missingness, we can better anticipate them and minimize their occurrence. Our preliminary analysis suggests missing TM data may not impact endpoint predictive ability, but could impact objective response status classification; however these findings require further validation. With response status accepted as an important phase II endpoint in the development of new cancer therapies (including immunotherapy), we urge that in CCT complete TM data collection and adherence to protocol-defined disease evaluation as closely as possible be a priority. Keywords: Missing data, Phase II, Tumor measurement-based endpoints, Cancer trials
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2451-8654
Relation: http://www.sciencedirect.com/science/article/pii/S2451865419302546; https://doaj.org/toc/2451-8654
DOI: 10.1016/j.conctc.2019.100492
Access URL: https://doaj.org/article/975608b1cfed44849fd35ce68d122996
Accession Number: edsdoj.975608b1cfed44849fd35ce68d122996
Database: Directory of Open Access Journals
More Details
ISSN:24518654
DOI:10.1016/j.conctc.2019.100492
Published in:Contemporary Clinical Trials Communications
Language:English