Reporting of patient characteristics and stratification factors in phase 3 trials investigating first-line systemic treatment of metastatic colorectal cancer: A systematic review

Kaitlyn K.H. Goey, Remi Mahmoud, Halfdan Sørbye, Bengt Glimelius, Claus Henning Köhne, Daniel J. Sargent, Cornelis J.A. Punt, Martijn G.H. van Oijen, Miriam Koopman

Research output: Contribution to journalReview article

Abstract

Background: Patient characteristics and stratification factors are important factors influencing trial outcomes. Uniform reporting on these parameters would facilitate cross-study comparisons and extrapolation of trial results to clinical practice. In 2007, standardisation on patient characteristics reporting and stratification in metastatic colorectal cancer (mCRC) trials was proposed. We investigated the reporting of prognostic factors and implementation of this proposal in mCRC trials published from 2005 to 2016. Methods: We searched PubMed and Embase (January 2005 – June 2016) for first-line phase 3 mCRC trials. Patient characteristics reporting and use of stratification factors were extracted and analysed for adherence to the proposal from 2007. Results: Sixty-seven trials (35,315 patients) were identified, reporting 48 different patient characteristics (median: 9 [range: 5–18] per study). Age, gender, performance status (PS), primary tumour site and adjuvant chemotherapy were frequently reported (87%–100%), in contrast to laboratory values, such as alkaline phosphatase, lactate dehydrogenase and white blood cell count (10%–25%). We identified 29 different stratification factors (median: 3 [range: 1–9] per study). The most common strata were PS and treatment centre (>60%). A median of 8/12 (range: 4–11) of the proposed parameters was reported. Although the percentage of studies reporting each factor slightly increased over time, there was no significant correlation between publication year and adherence to the proposal from 2007. Conclusions: We observed persistent heterogeneity in the reporting of patient characteristics and use of stratification factors in first-line mCRC trials. The proposal from 2007 has not led to increased uniformity of patient characteristics reporting and use of stratification over time. There is an urgent need to address this issue to improve the interpretation of trial results.

Original languageEnglish (US)
Pages (from-to)115-124
Number of pages10
JournalEuropean Journal of Cancer
Volume96
DOIs
StatePublished - Jun 1 2018

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Colorectal Neoplasms
Therapeutics
Adjuvant Chemotherapy
Leukocyte Count
L-Lactate Dehydrogenase
PubMed
Alkaline Phosphatase
Publications
Neoplasms

Keywords

  • Clinical trials
  • Colorectal cancer
  • Metastatic disease
  • Patient characteristics
  • Prognosis
  • Stratification
  • Systematic review

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Reporting of patient characteristics and stratification factors in phase 3 trials investigating first-line systemic treatment of metastatic colorectal cancer : A systematic review. / Goey, Kaitlyn K.H.; Mahmoud, Remi; Sørbye, Halfdan; Glimelius, Bengt; Köhne, Claus Henning; Sargent, Daniel J.; Punt, Cornelis J.A.; van Oijen, Martijn G.H.; Koopman, Miriam.

In: European Journal of Cancer, Vol. 96, 01.06.2018, p. 115-124.

Research output: Contribution to journalReview article

Goey, Kaitlyn K.H. ; Mahmoud, Remi ; Sørbye, Halfdan ; Glimelius, Bengt ; Köhne, Claus Henning ; Sargent, Daniel J. ; Punt, Cornelis J.A. ; van Oijen, Martijn G.H. ; Koopman, Miriam. / Reporting of patient characteristics and stratification factors in phase 3 trials investigating first-line systemic treatment of metastatic colorectal cancer : A systematic review. In: European Journal of Cancer. 2018 ; Vol. 96. pp. 115-124.
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abstract = "Background: Patient characteristics and stratification factors are important factors influencing trial outcomes. Uniform reporting on these parameters would facilitate cross-study comparisons and extrapolation of trial results to clinical practice. In 2007, standardisation on patient characteristics reporting and stratification in metastatic colorectal cancer (mCRC) trials was proposed. We investigated the reporting of prognostic factors and implementation of this proposal in mCRC trials published from 2005 to 2016. Methods: We searched PubMed and Embase (January 2005 – June 2016) for first-line phase 3 mCRC trials. Patient characteristics reporting and use of stratification factors were extracted and analysed for adherence to the proposal from 2007. Results: Sixty-seven trials (35,315 patients) were identified, reporting 48 different patient characteristics (median: 9 [range: 5–18] per study). Age, gender, performance status (PS), primary tumour site and adjuvant chemotherapy were frequently reported (87{\%}–100{\%}), in contrast to laboratory values, such as alkaline phosphatase, lactate dehydrogenase and white blood cell count (10{\%}–25{\%}). We identified 29 different stratification factors (median: 3 [range: 1–9] per study). The most common strata were PS and treatment centre (>60{\%}). A median of 8/12 (range: 4–11) of the proposed parameters was reported. Although the percentage of studies reporting each factor slightly increased over time, there was no significant correlation between publication year and adherence to the proposal from 2007. Conclusions: We observed persistent heterogeneity in the reporting of patient characteristics and use of stratification factors in first-line mCRC trials. The proposal from 2007 has not led to increased uniformity of patient characteristics reporting and use of stratification over time. There is an urgent need to address this issue to improve the interpretation of trial results.",
keywords = "Clinical trials, Colorectal cancer, Metastatic disease, Patient characteristics, Prognosis, Stratification, Systematic review",
author = "Goey, {Kaitlyn K.H.} and Remi Mahmoud and Halfdan S{\o}rbye and Bengt Glimelius and K{\"o}hne, {Claus Henning} and Sargent, {Daniel J.} and Punt, {Cornelis J.A.} and {van Oijen}, {Martijn G.H.} and Miriam Koopman",
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T1 - Reporting of patient characteristics and stratification factors in phase 3 trials investigating first-line systemic treatment of metastatic colorectal cancer

T2 - A systematic review

AU - Goey, Kaitlyn K.H.

AU - Mahmoud, Remi

AU - Sørbye, Halfdan

AU - Glimelius, Bengt

AU - Köhne, Claus Henning

AU - Sargent, Daniel J.

AU - Punt, Cornelis J.A.

AU - van Oijen, Martijn G.H.

AU - Koopman, Miriam

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: Patient characteristics and stratification factors are important factors influencing trial outcomes. Uniform reporting on these parameters would facilitate cross-study comparisons and extrapolation of trial results to clinical practice. In 2007, standardisation on patient characteristics reporting and stratification in metastatic colorectal cancer (mCRC) trials was proposed. We investigated the reporting of prognostic factors and implementation of this proposal in mCRC trials published from 2005 to 2016. Methods: We searched PubMed and Embase (January 2005 – June 2016) for first-line phase 3 mCRC trials. Patient characteristics reporting and use of stratification factors were extracted and analysed for adherence to the proposal from 2007. Results: Sixty-seven trials (35,315 patients) were identified, reporting 48 different patient characteristics (median: 9 [range: 5–18] per study). Age, gender, performance status (PS), primary tumour site and adjuvant chemotherapy were frequently reported (87%–100%), in contrast to laboratory values, such as alkaline phosphatase, lactate dehydrogenase and white blood cell count (10%–25%). We identified 29 different stratification factors (median: 3 [range: 1–9] per study). The most common strata were PS and treatment centre (>60%). A median of 8/12 (range: 4–11) of the proposed parameters was reported. Although the percentage of studies reporting each factor slightly increased over time, there was no significant correlation between publication year and adherence to the proposal from 2007. Conclusions: We observed persistent heterogeneity in the reporting of patient characteristics and use of stratification factors in first-line mCRC trials. The proposal from 2007 has not led to increased uniformity of patient characteristics reporting and use of stratification over time. There is an urgent need to address this issue to improve the interpretation of trial results.

AB - Background: Patient characteristics and stratification factors are important factors influencing trial outcomes. Uniform reporting on these parameters would facilitate cross-study comparisons and extrapolation of trial results to clinical practice. In 2007, standardisation on patient characteristics reporting and stratification in metastatic colorectal cancer (mCRC) trials was proposed. We investigated the reporting of prognostic factors and implementation of this proposal in mCRC trials published from 2005 to 2016. Methods: We searched PubMed and Embase (January 2005 – June 2016) for first-line phase 3 mCRC trials. Patient characteristics reporting and use of stratification factors were extracted and analysed for adherence to the proposal from 2007. Results: Sixty-seven trials (35,315 patients) were identified, reporting 48 different patient characteristics (median: 9 [range: 5–18] per study). Age, gender, performance status (PS), primary tumour site and adjuvant chemotherapy were frequently reported (87%–100%), in contrast to laboratory values, such as alkaline phosphatase, lactate dehydrogenase and white blood cell count (10%–25%). We identified 29 different stratification factors (median: 3 [range: 1–9] per study). The most common strata were PS and treatment centre (>60%). A median of 8/12 (range: 4–11) of the proposed parameters was reported. Although the percentage of studies reporting each factor slightly increased over time, there was no significant correlation between publication year and adherence to the proposal from 2007. Conclusions: We observed persistent heterogeneity in the reporting of patient characteristics and use of stratification factors in first-line mCRC trials. The proposal from 2007 has not led to increased uniformity of patient characteristics reporting and use of stratification over time. There is an urgent need to address this issue to improve the interpretation of trial results.

KW - Clinical trials

KW - Colorectal cancer

KW - Metastatic disease

KW - Patient characteristics

KW - Prognosis

KW - Stratification

KW - Systematic review

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