Efficacy endpoint changes in glioblastoma phase II clinical trials and the factors contributing to these changes

Tsukuba, Japan—Clinical trials are conducted primarily to confirm the efficacy and safety of drugs. In the case of early-stage clinical trials for cancer, the response rate (ORR) based on the response criteria for solid tumors are typically used as the standard efficacy endpoint. However, for glioblastoma (GBM), a high-grade brain tumor, a different measure has been used because of its unique biological characteristics, such as its ability to spread into the surrounding brain tissue, often making evaluation using solid tumor efficacy criteria inappropriate.

In this study, researchers analyzed the trends in efficacy endpoints established in GBM phase II clinical trials conducted worldwide in FY 2020-2022 and compared them with historical data (FY 2017-2019). Findings revealed that 101 primary endpoints (PEs) were set in 88 trials in FY2020-2022, indicating that more time-to-event measures of cancer progression control and patient survival are being used than ever before. In particular, the progression-free survival (PFS) of 22% of subjects, the overall survival (OS) of 20% of subjects, and the PFS rate of 17% of subjects were the most commonly selected PEs used in the trials. In contrast, ORR was used as PE in only 8% of trials, indicating a significant decrease compared to 20% in FY 2017-2019. These data reveal a trend toward shifting the efficacy endpoint setting from ORR to PFS and OS. The researchers also confirmed a diversification in the types of PEs across trials and a shift toward trial designs that combine multiple endpoints rather than being biased toward specific endpoints.

These trends identified in this study reflect the complexity of GBM treatment evaluation and may indicate that clinical trial design is evolving toward more comprehensive and real-world clinical practice.

The findings from this study may guide clinical trial design, providing an essential step toward overcoming the challenges in evaluating GBM treatment and establishing more clinically relevant metrics.

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This research was supported by the Japan Agency for Medical Research and Development
(AMED) (grant number JP24mk0101235).

_{Original Paper}

Title of original paper:
Trends in Efficacy Endpoints in Phase II Glioblastoma Trials: A Regulatory Science Analysis (FY2020-FY2022).

Journal:
Cancers

DOI:
10.3390/cancers17050855

_{Correspondence}

Assistant Professor WATANABE, Shinya
Institute of Medicine, University of Tsukuba

_{Related Link}

Institute of Medicine