Larynx preservation clinical trial design: key issues and recommendations--a consensus panel summary.

Details

Serval ID
serval:BIB_9D4D4F9AD0AC
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Larynx preservation clinical trial design: key issues and recommendations--a consensus panel summary.
Journal
Head and Neck
Author(s)
Lefebvre J.L., Ang K.K.
Working group(s)
Larynx Preservation Consensus Panel
Contributor(s)
Ang K., Bardet E., Barry B., Bernier J., Bourhis J., Budach V., Calais G., Conley B., Forastiere A., Knecht R., Langendijk J., Lefebvre JL., Leemans R., Licitra L., Posner M., de Raucourt D., Rolland F., Temam S., Vermorken JB., Vokes E., Weber RS., Wolf G.
ISSN
1097-0347 (Electronic)
ISSN-L
1043-3074
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
31
Number
4
Pages
429-441
Language
english
Notes
Publication types: Consensus Development Conference ; Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish, pdf : Consensus Document
Abstract
BACKGROUND: To develop guidelines for the conduct of phase III clinical trials of larynx preservation in patients with locally advanced laryngeal and hypopharyngeal cancer.
METHODS: A multidisciplinary international consensus panel developed recommendations after reviewing results from completed phase III randomized trials, meta-analyses, and published clinical reports with updates available through November 2007. The guidelines were reviewed and approved by the panel.
RESULTS: The trial population should include patients with T2 or T3 laryngeal or hypopharyngeal squamous cell carcinoma not considered for partial laryngectomy and exclude those with laryngeal dysfunction or age more than 70 years. Functional assessments should include speech and swallowing. Voice should be routinely assessed with a simple, validated instrument. The primary endpoint should capture survival and function. The panel created a new endpoint: laryngo-esophageal dysfunction-free survival. Events are death, local relapse, total or partial laryngectomy, tracheotomy at 2 years or later, or feeding tube at 2 years or later. Recommended secondary endpoints are overall survival, progression-free survival, locoregional control, time to tracheotomy, time to laryngectomy, time to discontinuation of feeding tube, and quality of life/patient reported outcomes. Correlative biomarker studies for near-term trials should include EGFR, ERCC-1, E-cadherin and beta-catenin, epiregulin and amphiregulin, and TP53 mutation.
CONCLUSIONS: Revised trial designs in several key areas are needed to advance the study of larynx preservation. With consistent methodologies, clinical trials can more effectively evaluate and quantify the therapeutic benefit of novel treatment options for patients with locally-advanced laryngeal and hypopharyngeal cancer.
Keywords
Carcinoma, Squamous Cell/mortality, Carcinoma, Squamous Cell/pathology, Clinical Trials, Phase III as Topic/standards, Combined Modality Therapy, Deglutition, Disease-Free Survival, Guidelines as Topic, Humans, Hypopharyngeal Neoplasms/mortality, Hypopharyngeal Neoplasms/pathology, Laryngeal Neoplasms/mortality, Laryngeal Neoplasms/pathology, Laryngectomy, Larynx/physiopathology, Speech, Survival Rate
Pubmed
Web of science
Create date
01/12/2014 17:21
Last modification date
20/08/2019 15:03
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