Cancer Trials: Patient-Reported Outcomes Should Measure Five Core Concepts, US FDA Says
Heterogeneity in PRO assessment strategies has lessened the regulatory utility of such data from cancer trials, the agency says; new draft guidance recommends systematic assessment of a core set of PROs in registrational studies using fit-for-purpose tools and includes examples of acceptable instruments.
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A single-item instrument can capture cumulative effects of low-grade drug toxicities, informing dose selection and de-risking development programs. However, administration of those measures at baseline in treatment-naïve patients is problematic, and practical challenges and regulatory uncertainties have inhibited broad adoption by sponsors, FDA workshop participants say.
With the expectation for increasing amounts of patient experience data comes the need for the FDA and sponsors to consider, and account for, the degree to which open-label bias influences oncology trial PROs; agency staff suggest trial design elements and analytic approaches for dealing with bias at a meeting on cancer clinical outcomes assessments.
As a part of real-world evidence, patient-reported outcomes can serve to evaluate a drug's efficacy against primary or secondary endpoints and also reflect safety and quality of life, notes a just-released draft regulation from China’s Center for Drug Evaluation.