SGO guidance document for clinical trial designs in ovarian cancer: A changing paradigm

Journal Article

© 2014 Elsevier Inc.Objective. To explore and facilitate themultifaceted process of drug development and regulatory approval in ovarian cancer.Methods. The Society of Gynecologic Oncology (SGO) recently sought and received input from multiple stakeholders including the National Cancer Institute's (NCI) Clinical Therapy Evaluation Program (CTEP), the Food and Drug Administration (FDA), pharmaceutical industry, and patient advocates. This whitepaper is the work product and opinion solely of the SGO.Results. This document summarizes the SGO's interpretation of these meetings and the current regulatory environment where there has been a paucity of recent approvals in the United States. It provides guidance in clinical trial design with the express purpose of encouraging novel drug development in ovarian cancer. Points of emphasis include: ovarian cancer heterogeneity (histologic subtypes and molecular genetic alterations), clinical trial design elements, surrogate as well as composite endpoints, and the four principles of clinical drug development (unmet medical need, discovery, safety, and efficacy).Conclusions. There has been an evolution in the acceptance of surrogate endpoints depending upon the clinical setting in ovarian cancer. While overall survival (OS) remains the most objective clinical trial endpoint, there is now realization that demanding OS as the primary endpoint has many obstacles. Ovarian cancer is a heterogeneous disease that is now divided by histologic subtypes. Future registration strategies will need to address disease heterogeneity. The exploration of currently acceptable clinical trial endpoints and alternative regulatory strategies will hopefully stimulate interest in novel drug development for patients with ovarian cancer.

Full Text

Duke Authors

Cited Authors

  • Herzog, TJ; Alvarez, RD; Secord, A; Goff, BA; Mannel, RS; Monk, BJ; Coleman, RL

Published Date

  • 2014

Published In

Volume / Issue

  • 135 / 1

Start / End Page

  • 3 - 7

International Standard Serial Number (ISSN)

  • 0090-8258

Digital Object Identifier (DOI)

  • 10.1016/j.ygyno.2014.08.004