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

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• 作者：J. Brian Cassel ; PhD^a ; ^{jbcassel@vcu.edu" class="auth_mail" title="E-mail the corresponding author} ; Egidio Del Fabbro ; MD^a ; Tobias Arkenau ; MD ; PhD^b ; Irene J. Higginson ; BM ; BS ; BMedSci ; PhD ; FFPHM ; FRCP^c ; Samia Hurst ; MD^d ; Lynn A. Jansen ; RN ; PhD^e ; Andrew Poklepovic ; MD^a ; Annette Rid ; MD^f ; Jordi Rodó ; n ; MD^g ; Florian Strasser ; MD ; ABHPM^h ; Franklin G. Miller ; PhDⁱ
• 关键词：Palliative care ; Phase I clinical trials ; cancer ; ethics ; informed consent ; end-of-life care
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：52
• 期：3
• 页码：437-445
• 全文大小：212 K

文摘

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.