A comprehensive analysis of clinical trials in pancreatic cancer: what is coming down the pike?
A comprehensive analysis of clinical trials in pancreatic cancer: what is coming down the pike?
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DOI：
10.18632/oncotarget.27727
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发表时间：
2020-09-22
期刊：
影响因子：
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通讯作者：
Winter JM
中科院分区：
文献类型：
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作者：
Katayama ES;Hue JJ;Bajor DL;Ocuin LM;Ammori JB;Hardacre JM;Winter JM
目的：胰腺癌是最具侵袭性的常见癌症，迫切需要新的治疗方法。与许多其他常见癌症不同的是，在过去的40年里，除了多药化疗之外，还没有新的改变范式的治疗方法。在这项研究中，我们首先对目前胰腺癌的临床试验情况进行了全面的分析，以更好地了解新疗法的流水线。材料和方法：我们在https://clinicaltrials.gov/上查询注册的胰腺癌临床试验。研究根据研究阶段、研究人群的临床阶段、调查中的干预类型以及研究中所针对的生物机制进行管理和分类。结果：截至2019年5月18日，共有430项积极的治疗干预试验，测试了590项干预措施。绝大多数试验(n=37，8.6%)处于第三阶段试验。189个(31%)干预措施是免疫疗法，69个(11%)靶细胞信号通路，154个(26%)靶细胞周期或DNA生物学，35个(6%)靶代谢通路。在后期试验中，目前只有14项正在测试新的干预措施。相反，23个第三阶段试验检查了提供现有FDA批准的药物、程序或疼痛控制的新方法。结论：目前正在研究大量新的治疗策略。它们包括针对不同生物过程的广泛疗法。然而，只有一小部分新疗法处于后期测试阶段，这表明未来的进展可能还需要几年时间，并取决于早期试验的成功。
Objective: Pancreatic cancer is the most aggressive common cancer and is desperately in need of novel therapies. Unlike many other common cancers, there have been no new paradigm-changing therapies in the past 40 years beyond multi-agent chemotherapy. In this study, we perform the first comprehensive analysis of the current clinical trial landscape in pancreatic cancer to better understand the pipeline of new therapies. Materials and Methods: We queried https://clinicaltrials.gov/ for registered pancreatic cancer clinical trials. Studies were curated and categorized according to phase of study, clinical stage of the study population, type of the intervention under investigation, and biologic mechanism targeted by the therapy under study. Results: As of May 18, 2019, there were 430 total active therapeutic interventional trials testing 590 interventions. The vast minority of trials (n = 37, 8.6%) are in phase III testing. 189 (31%) interventions are immunotherapies, 69 (11%) target cell signaling pathways, 154 (26%) target cell cycle or DNA biology, and 35 (6%) target metabolic pathways. Of the late phase trials, only 14 are currently testing novel interventions. Rather, 23 phase III trials examine new ways to deliver existing FDA-approved drugs, procedures, or pain management. Conclusions: A large number of novel therapeutic strategies are currently under investigation. They include a broad range of therapies targeting diverse biologic processes. However, only a small number of novel therapies are in late-stage testing, suggesting that future progress is likely several years away, and dependent on the success of early-stage trials.