The current role and limitations of surrogate endpoints in advanced prostate cancer.

Publication/Presentation Date

1-1-2014

Abstract

OBJECTIVES: The identification of appropriate surrogate endpoints for evaluating cancer therapeutics has been of ongoing interest across various tumor types. Metastatic castrate-resistant prostate cancer (mCRPC) has been a particularly challenging area. As more targeted and novel therapies are being developed in this disease space, an urgent need exists to identify surrogate endpoints in mCRPC. The ability to discern patient benefit in the absence of patient death or other complications would facilitate both drug development and more appropriate patient care.

METHODS AND MATERIALS: We reviewed the available literature and guidelines used in the development and approval of recent agents for mCRPC.

RESULTS: The majority of regulatory approvals of new medications have relied on overall survival (OS) or prevention of complications such as skeletal related events (SRE's). Progression-free survival measures, such as bone scans, computed tomography scans, and prostate-specific antigen related changes, have not been validated nor uniformly accepted as outcome surrogates. All of the successful recent pivotal Phase III trials designed to achieve regulatory approval in mCRPC have used either OS or SRE's as the primary endpoint.

CONCLUSIONS: There are significant problematic issues that exist associated with defining and implementing surrogate markers in mCRPC beyond survival and complications. Suggestions are made as to how the current situation might be improved.

Volume

32

Issue

1

First Page

1

Last Page

9

ISSN

1873-2496

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

23433893

Department(s)

Administration and Leadership

Document Type

Article

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