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Thyroid Cancer Trials

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Practical Management of Thyroid Cancer

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Abstract

Readers are already familiar with treatments for thyroid cancer, and there have been several highly successful trials in recent years. This chapter aims to provide an overview of some of the main design and analysis features of modern clinical trials in thyroid cancer. Examples from the literature are used throughout to illustrate various concepts. Key issues in early phase trials include having more sophisticated but efficient phase I designs; and the use of a randomised phase II trial with a control arm, and consideration of the value of placebo, acknowledging that whilst single arm studies have potential limitations with design and interpretation, they can still provide a useful evaluation of a new therapy or new combination. Large randomised phase III trials are no longer unfeasible, following the successful design and conduct of practice-changing trials for patients with advanced disease (more effective therapies) and low risk patients (reducing/avoiding unnecessary interventions). Each type of design (superiority and non-inferiority) have specific considerations (e.g. the value of progression-free survival, or feasibility). More immunotherapy trials are likely to be conducted for thyroid cancer, and the interpretation of some of their results require care. Finally, the application of biomarkers is likely to be central to finding better therapies and for identifying patients unlikely to benefit from a certain treatment (avoiding their side effects).

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Authors and Affiliations

  1. Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK

    Allan Hackshaw

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  1. Allan Hackshaw
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Correspondence to Allan Hackshaw .

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Editors and Affiliations

  1. Consultant (Hon), Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK

    Ujjal K. Mallick

  2. London, UK

    Clive Harmer

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Hackshaw, A. (2018). Thyroid Cancer Trials. In: Mallick, U.K., Harmer, C. (eds) Practical Management of Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-91725-2_25

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  • DOI: https://doi.org/10.1007/978-3-319-91725-2_25

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