Proposal for standardized definitions for efficacy end points in adjuvant breast cancer trials: The STEEP system Journal Article


Authors: Hudis, C. A.; Barlow, W. E.; Costantino, J. P.; Gray, R. J.; Pritchard, K. I.; Chapman, J. A. W.; Sparano, J. A.; Hunsberger, S.; Enos, R. A.; Gelber, R. D.; Zujewski, J. A.
Article Title: Proposal for standardized definitions for efficacy end points in adjuvant breast cancer trials: The STEEP system
Abstract: Purpose: Standardized definitions of breast cancer clinical trial end points must be adopted to permit the consistent interpretation and analysis of breast cancer clinical trials and to facilitate cross-trial comparisons and meta-analyses. Standardizing terms will allow for uniformity in data collection across studies, which will optimize clinical trial utility and efficiency. A given end point term (eg, overall survival) used in a breast cancer trial should always encompass the same set of events (eg, death attributable to breast cancer, death attributable to cause other than breast cancer, death from unknown cause), and, in turn, each event within that end point should be commonly defined across end points and studies. Methods: A panel of experts in breast cancer clinical trials representing medical oncology, biostatistics, and correlative science convened to formulate standard definitions and address the confusion that nonstandard definitions of widely used end point terms for a breast cancer clinical trial can generate. We propose standard definitions for efficacy end points and events in early-stage adjuvant breast cancer clinical trials. In some cases, it is expected that the standard end points may not address a specific trial question, so that modified or customized end points would need to be prospectively defined and consistently used. Conclusion: The use of the proposed common end point definitions will facilitate interpretation of trial outcomes. This approach may be adopted to develop standard outcome definitions for use in trials involving other cancer sites. © 2007 by American Society of Clinical Oncology.
Keywords: cancer survival; survival rate; overall survival; clinical trial; mortality; cancer recurrence; adjuvant therapy; disease free survival; chemotherapy, adjuvant; radiotherapy, adjuvant; follow up; neoplasm recurrence, local; breast cancer; pathology; breast neoplasms; cancer invasion; standard; tumor recurrence; adjuvant chemotherapy; breast tumor; bioassay; clinical research; lung carcinoma; neoplasm invasiveness; endpoint determination; paget nipple disease; carcinoma, intraductal, noninfiltrating; clinical trials; carcinoma, ductal, breast; carcinoma, lobular
Journal Title: Journal of Clinical Oncology
Volume: 25
Issue: 15
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2007-05-20
Start Page: 2127
End Page: 2132
Language: English
DOI: 10.1200/jco.2006.10.3523
PUBMED: 17513820
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 75" - "Export Date: 17 November 2011" - "CODEN: JCOND" - "Source: Scopus"
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  1. Clifford Hudis
    905 Hudis