Secondary Endpoint Utilization and Publication Rate among Phase III Oncology Trials.

Authors

Esther J Beck
Alexander D Sherry
Marcus A Florez
Ramez Kouzy
Joseph Abi Jaoude
Timothy A Lin
Avital M Miller
Adina H Passy
Gabrielle S Kupferman
Roshal R Patel
Fumiko Chino
Victoria Serpas Higbie
Christine M Parseghian
Michael J Overman
Bruce D Minsky
Charles R Thomas
Chad Tang
Pavlos Msaouel
Ethan B Ludmir

Publication Date

8-1-2024

Journal

Cancer Research Communications

Abstract

UNLABELLED: Secondary endpoints (SEP) provide crucial information in the interpretation of clinical trials, but their features are not yet well understood. Thus, we sought to empirically characterize the scope and publication rate of SEPs among late-phase oncology trials. We assessed SEPs for each randomized, published phase III oncology trial across all publications and ClinicalTrials.gov, performing logistic regressions to evaluate associations between trial characteristics and SEP publication rates. After screening, a total of 280 trials enrolling 244,576 patients and containing 2,562 SEPs met the inclusion criteria. Only 22% of trials (62/280) listed all SEPs consistently between ClinicalTrials.gov and the trial protocol. The absolute number of SEPs per trial increased over time, and trials sponsored by industry had a greater number of SEPs (median 9 vs. 5 SEPs per trial; P < 0.0001). In total, 69% of SEPs (1,770/2,562) were published. The publication rate significantly varied by SEP category [X2 (5, N = 2,562) = 245.86; P < 0.001]. SEPs that place the most burden on patients, such as patient-reported outcomes and translational correlatives, were published at 63% (246/393) and 44% (39/88), respectively. Trials with more SEPs were associated with lower overall SEP publication rates. Overall, our findings are that SEP publication rates in late-phase oncology trials are highly variable based on the type of SEP. To avoid undue burden on patients and promote transparency of findings, trialists should weigh the biological and clinical relevance of each SEP together with its feasibility at the time of trial design.

SIGNIFICANCE: In this investigation, we characterized the utilization and publication rates of SEPs among late-phase oncology trials. Our results draw attention to the proliferation of SEPs in recent years. Although overall publication rates were high, underpublication was detected among endpoints that may increase patient burden (such as translational correlatives and patient-reported outcomes).

Keywords

Humans, Clinical Trials, Phase III as Topic, Neoplasms, Medical Oncology, Randomized Controlled Trials as Topic, Endpoint Determination

Comments

Supplementary Materials

Data Availability Statement

PMID: 39099199