Phase I Cancer Trials and Palliative Care: Antagonism, Irrelevance, or Synergy?

被引：25

作者：

Cassel, J. Brian ^{[1
]}

Del Fabbro, Egidio ^{[1
]}

Arkenau, Tobias ^{[2
,3
]}

Higginson, Irene J. ^{[4
]}

Hurst, Samia ^{[5
]}

Jansen, Lynn A. ^{[6
]}

Poklepovic, Andrew ^{[1
]}

Rid, Annette ^{[7
]}

Rodon, Jordi ^{[8
]}

Strasser, Florian ^{[9
]}

Miller, Franklin G. ^{[10
]}

机构：

[1] Virginia Commonwealth Univ, Richmond, VA USA

[2] Sarah Cannon Res Inst, London, England

[3] UCL, London, England

[4] Kings Coll London, Cicely Saunders Inst, London, England

[5] Ctr Med Univ Geneva, Inst Eth Biomed, Geneva, Switzerland

[6] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[7] Kings Coll London, London, England

[8] Vall dHebron Inst Oncol, Barcelona, Spain

[9] Kantonsspital St Gallen, ABHPM, St Gallen, Switzerland

[10] NIH, Bldg 10, Bethesda, MD 20892 USA

来源：

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT | 2016年 / 52卷 / 03期

关键词：

Palliative care; Phase I clinical trials; cancer; ethics; informed consent; end-of-life care; MOLECULARLY TARGETED AGENTS; QUALITY-OF-LIFE; CLINICAL-TRIALS; PATIENT SELECTION; ONCOLOGY TRIALS; SYMPTOM BURDEN; MEDICINE; BENEFITS; SURVIVAL; RISKS;

D O I：

10.1016/j.jpainsymman.2016.02.014

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

This article synthesizes the presentations and conclusions of an international symposium on Phase 1 oncology trials, palliative care, and ethics held in 2014. The purpose of the symposium was to discuss the intersection of three independent trends that unfolded in the past decade. First, large-scale reviews of hundreds of Phase I trials have indicated there is a relatively low risk of serious harm and some prospect of clinical benefit that can be meaningful to patients. Second, changes in the design and analysis of Phase I trials, the introduction of ''targeted'' investigational agents that are generally less toxic, and an increase in Phase I trials that combine two or more agents in a novel way have changed the conduct of these trials and decreased fears and apprehensions about participation. Third, the field of palliative care in cancer has expanded greatly, offering symptom management to late-stage cancer patients, and demonstrated that it is not mutually exclusive with disease-targeted therapies or clinical research. Opportunities for collaboration and further research at the intersection of Phase 1 oncology trials and palliative care are highlighted. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

引用

页码：437 / 445

页数：9

共 78 条

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