unmet need

未满足的需求
  • 文章类型: Journal Article
    背景:局部晚期(不可切除)或转移性去分化脂肪肉瘤(DDLPS)是脂肪肉瘤的常见表现。尽管建立了DDLPS的诊断和治疗指南,关键的临床差距仍然由诊断挑战驱动,症状负担和缺乏针对性,安全有效的治疗方法。这项研究的目的是收集欧洲和美国对管理的专家意见,该疾病的临床试验设计以及无进展生存期(PFS)的价值未满足的需求和期望。其他目标包括提高认识和教育整个医疗保健系统的关键利益相关者。
    方法:招募了一个由12名肉瘤关键意见领袖(KOL)组成的国际小组。该研究包括两轮带有预定义陈述的调查。专家以9分的李克特量表对每个陈述进行评分。共识被定义为≥75%的专家对陈述评分≥7。在协商一致会议上讨论了订正声明。
    结果:关于疾病负担的55项预定义陈述中的43项达成了共识,治疗范式,未满足的需求,PFS的价值及其与总生存期(OS)的关系,和交叉试验设计。12个语句被取消优先级或与其他语句合并。没有专家不同意的陈述。
    结论:本研究构成了第一个关于DDLPS的国际Delphi小组。它旨在探索KOL对DDLPS中疾病负担和未满足需求的看法,PFS的值,以及它潜在的转化为操作系统的好处,以及DDLPS治疗交叉试验设计的相关性。结果表明,欧洲和美国在DDLPS管理方面保持一致,未满足的需求,和对临床试验的期望。提高对与DDLPS相关的关键临床差距的认识可以有助于改善患者预后并支持创新治疗方法的开发。
    BACKGROUND: Locally advanced (unresectable) or metastatic dedifferentiated liposarcoma (DDLPS) is a common presentation of liposarcoma. Despite established diagnostic and treatment guidelines for DDLPS, critical clinical gaps remain driven by diagnostic challenges, symptom burden and the lack of targeted, safe and effective treatments. The objective of this study was to gather expert opinions from Europe and the United States on the management, unmet needs and expectations for clinical trial design as well as the value of progression-free survival (PFS) in this disease. Other aims included raising awareness and educate key stakeholders across healthcare systems.
    METHODS: An international panel of 12 sarcoma key opinion leaders (KOLs) was recruited. The study consisted of two rounds of surveys with pre-defined statements. Experts scored each statement on a 9-point Likert scale. Consensus agreement was defined as ≥75% of experts scoring a statement with ≥7. Revised statements were discussed in a consensus meeting.
    RESULTS: Consensus was reached on 43 of 55 pre-defined statements across disease burden, treatment paradigm, unmet needs, value of PFS and its association with overall survival (OS), and cross-over trial design. Twelve statements were deprioritised or merged with other statements. There were no statements where experts disagreed.
    CONCLUSIONS: This study constitutes the first international Delphi panel on DDLPS. It aimed to explore KOL perception of the disease burden and unmet need in DDLPS, the value of PFS, and its potential translation to OS benefit, as well as the relevance of a cross-over trial design for DDLPS therapies. Results indicate an alignment across Europe and the United States regarding DDLPS management, unmet needs, and expectations for clinical trials. Raising awareness of critical clinical gaps in relation to DDLPS can contribute to improving patient outcomes and supporting the development of innovative treatments.
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