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Making progress in early breast cancer: Taking time or accepting risk?
Outcomes for patients diagnosed with early breast cancer in developed countries have improved substantially over recent decades. Adjuvant therapies have contributed to this improvement and their benefits have been confirmed in large randomised controlled trials (RCTs) and meta-analyses. Lower event...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Science Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446260/ https://www.ncbi.nlm.nih.gov/pubmed/28411447 http://dx.doi.org/10.1016/j.ejca.2017.03.005 |
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author | Mannu, Gurdeep S. Dodwell, David |
author_facet | Mannu, Gurdeep S. Dodwell, David |
author_sort | Mannu, Gurdeep S. |
collection | PubMed |
description | Outcomes for patients diagnosed with early breast cancer in developed countries have improved substantially over recent decades. Adjuvant therapies have contributed to this improvement and their benefits have been confirmed in large randomised controlled trials (RCTs) and meta-analyses. Lower event rates, whilst welcome, have created problems for RCTs, that need to be larger and often take longer to provide a reliable result. In an effort to maintain the rate of progress and to obviate the complexity, cost and time required to conduct large RCTs, there has been an increased tendency to rely on observational data to determine a treatment effect and also to accelerate progress by the use of a surrogate marker (pathological complete remission after neoadjuvant chemotherapy). We highlight the pitfalls in these approaches and suggest some simplifications in the conduct of RCTs. |
format | Online Article Text |
id | pubmed-5446260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier Science Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-54462602017-06-01 Making progress in early breast cancer: Taking time or accepting risk? Mannu, Gurdeep S. Dodwell, David Eur J Cancer Current Perspective Outcomes for patients diagnosed with early breast cancer in developed countries have improved substantially over recent decades. Adjuvant therapies have contributed to this improvement and their benefits have been confirmed in large randomised controlled trials (RCTs) and meta-analyses. Lower event rates, whilst welcome, have created problems for RCTs, that need to be larger and often take longer to provide a reliable result. In an effort to maintain the rate of progress and to obviate the complexity, cost and time required to conduct large RCTs, there has been an increased tendency to rely on observational data to determine a treatment effect and also to accelerate progress by the use of a surrogate marker (pathological complete remission after neoadjuvant chemotherapy). We highlight the pitfalls in these approaches and suggest some simplifications in the conduct of RCTs. Elsevier Science Ltd 2017-06 /pmc/articles/PMC5446260/ /pubmed/28411447 http://dx.doi.org/10.1016/j.ejca.2017.03.005 Text en © 2017 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Current Perspective Mannu, Gurdeep S. Dodwell, David Making progress in early breast cancer: Taking time or accepting risk? |
title | Making progress in early breast cancer: Taking time or accepting risk? |
title_full | Making progress in early breast cancer: Taking time or accepting risk? |
title_fullStr | Making progress in early breast cancer: Taking time or accepting risk? |
title_full_unstemmed | Making progress in early breast cancer: Taking time or accepting risk? |
title_short | Making progress in early breast cancer: Taking time or accepting risk? |
title_sort | making progress in early breast cancer: taking time or accepting risk? |
topic | Current Perspective |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446260/ https://www.ncbi.nlm.nih.gov/pubmed/28411447 http://dx.doi.org/10.1016/j.ejca.2017.03.005 |
work_keys_str_mv | AT mannugurdeeps makingprogressinearlybreastcancertakingtimeoracceptingrisk AT dodwelldavid makingprogressinearlybreastcancertakingtimeoracceptingrisk |