Clinical trial designs for rare diseases: studies developed and discussed by the International Rare Cancers Initiative. Review uri icon

Overview

abstract

  • BACKGROUND: The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research. SETTINGS: The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional--usually randomized--clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed. RESULTS: The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design. INTERPRETATION: Trials can be designed using a wide array of possibilities. There is no 'one size fits all' solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases.

authors

  • Bogaerts, Jan
  • Sydes, Matthew R
  • Keat, Nicola
  • McConnell, Andrea
  • Benson, Al
  • Ho, Alan Loh
  • Roth, Arnaud
  • Fortpied, Catherine
  • Eng, Cathy
  • Peckitt, Clare
  • Coens, Corneel
  • Pettaway, Curtis
  • Arnold, Dirk
  • Hall, Emma
  • Marshall, Ernie
  • Sclafani, Francesco
  • Hatcher, Helen
  • Earl, Helena
  • Ray-Coquard, Isabelle
  • Paul, James
  • Blay, Jean-Yves
  • Whelan, Jeremy
  • Panageas, Kathy
  • Wheatley, Keith
  • Harrington, Kevin
  • Licitra, Lisa
  • Billingham, Lucinda
  • Hensley, Martee Leigh
  • McCabe, Martin
  • Patel, Poulam M
  • Carvajal, Richard
  • Wilson, Richard
  • Glynne-Jones, Rob
  • McWilliams, Rob
  • Leyvraz, Serge
  • Rao, Sheela
  • Nicholson, Steve
  • Filiaci, Virginia
  • Negrouk, Anastassia
  • Lacombe, Denis
  • Dupont, Elisabeth
  • Pauporté, Iris
  • Welch, John J
  • Law, Kate
  • Trimble, Ted
  • Seymour, Matthew

publication date

  • December 24, 2014

Research

keywords

  • Neoplasms
  • Randomized Controlled Trials as Topic
  • Rare Diseases

Identity

PubMed Central ID

  • PMC4639696

Scopus Document Identifier

  • 84922655364

Digital Object Identifier (DOI)

  • 10.1016/j.ejca.2014.10.027

PubMed ID

  • 25542058

Additional Document Info

volume

  • 51

issue

  • 3