Modelling prognostic capabilities of tumor size : application to colorectal cancer
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Descriptif
Epidemiologyand public health
In oncology, the international WHO and RECISTcriteria have allowed the standardization of tumor response evaluation in orderto identify the time of disease progression. These semi-quantitativemeasurements are often used as endpoints in phase II and phase III trials tostudy the efficacy of new therapies. However, through categorization of thecontinuous tumor size, information can be lost and they can be challenged byrecently developed methods of modeling biomarkers in a longitudinal way. Thus,it is of interest to compare the predictive ability of cancer progressionsbased on categorical criteria and quantitative measures of tumor size(left-censored due to detection limit problems) and/or appearance of new lesionson overall survival. We propose a joint model for a simultaneous analysis ofthree types of data: longitudinal marker, recurrent events and a terminalevent. A simulation study is performed and shows that the proposed trivariatemodel is appropriate for the practical use. We suggest statistical tools thatevaluate predictive accuracy for joint models to compare our model to modelsbased on categorical criteria and their components. We apply the model to arandomized phase III clinical trial of metastatic colorectal cancer, conductedby the Fédération Francophone de Cancérologie Digestive (FFCD 2000-05 trial),which assigned 410 patients to two therapeutic strategies with multiplesuccessive chemotherapy regimens.
Cette présentation a été donnée dans le cadre du BRIO SIRICscientific day 3 organisé annuellement par le SIRIC BRIO et qui a pour but deréunir tous les acteurs du SIRIC BRIO et plus largement de la cancérologie àBordeaux.
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