Abstract 1901
Background
AEs resulting from placebo administration have not been well studied in oncology. The aim of this study was to describe the incidence of AEs in the placebo arms of target and immunotherapy cancer drugs in all treatment settings, and to analyze their relation with AEs reported in the active arms of included trials.
Methods
Based on PRISMA guidelines, a systematic literature search was performed including phase 3, randomized, double-blind, placebo-controlled trials from 1/1/2000 to 1/5/19. Adjuvant and advanced-stage studies using targeted and immunotherapy were included. Trials involving active anticancer treatment in addition to placebo in the control group were excluded. Random-effects meta-analysis was performed to estimate the incidence of grade 3-4 placebo AEs.
Results
Of 4396 studies screened, 40 trials were eligible (adjuvant n = 14; advanced n = 26) including 10 cancer types and 28,520. Median incidence of any-grade placebo AEs was 90% (IQR 89-91%) in the adjuvant and 89.5% (IQR 72-96%) in the advanced trials. Grade 5 drug-related AEs were reported in 19 pts receiving placebo. 4 trials reported a higher frequency of grade 3-4 AEs in the placebo arm than in the active treatment arm. The overall, random-effects pooled incidence of grade 3-4 placebo AEs was 22% (95% CI, 17-27%; [I2= 95%]) for the adjuvant and 27% (95% CI, 20-35%; [I2= 97%]) for the advanced trials. No statistical differences were observed comparing both settings (Wilcoxon rank-sum test, P = 0.2). Frequency of grade 3-4 placebo AEs was found to be correlated between the treatment and placebo arms in both adjuvant (ρ = 0.5; P = .042) and advanced studies (ρ = 0.6; P = .003).
Conclusions
Placebo administration was associated with a substantial incidence of grade 3-4 placebo AEs in adjuvant and advanced settings. An association between the active treatment and placebo arms was observed in both scenarios. These findings should be taken into consideration by the medical community in the toxicity evaluation criteria of a placebo-controlled clinical trial.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2728 - MicroRNA expression and DNA methylation profiles do not distinguish between primary and recurrent well-differentiated liposarcoma
Presenter: Melissa Vos
Session: Poster Display session 1
Resources:
Abstract
3197 - Genomic Alterations, Tumor Mutation Burden and Prognosis of Chinese Cardiac Sarcoma Patients
Presenter: Na Zhu
Session: Poster Display session 1
Resources:
Abstract
4214 - Evaluation of a peptide-conjugated alkylator melflufen in osteosarcoma preclinical models
Presenter: Konstantin Byrgazov
Session: Poster Display session 1
Resources:
Abstract
2654 - Expression analysis of NHEJ and HR genes in Ewing sarcomas: indications of DSB repair dysfunction
Presenter: Anastasios Kyriazoglou
Session: Poster Display session 1
Resources:
Abstract
4383 - Epidemiology of Synovial Sarcoma in EU28 countries
Presenter: Nedra Joseph
Session: Poster Display session 1
Resources:
Abstract
1937 - Resection Of High-Grade Large Soft Tissue Sarcoma With Adequate Wide Margin Can Lead To Good Local Control Without Adjuvant Radiotherapy
Presenter: Toshiyuki Kunisada
Session: Poster Display session 1
Resources:
Abstract
3757 - Influence of eribulin on proliferation, migration and invasion properties of leiomyosarcoma cell line models
Presenter: Marta Mendiola
Session: Poster Display session 1
Resources:
Abstract
1040 - EREMISS: Efficacy of regorafenib (REG) as maintenance therapy in non-adipocytic soft tissue sarcomas (STS) having received 1st-line doxorubicin-based chemotherapy (Doxo-CT)
Presenter: Nicolas Penel
Session: Poster Display session 1
Resources:
Abstract
1048 - A Phase 2 biomarker-driven study evaluating the clinical efficacy of an MDM2 inhibitor, milademetan, in patients with intimal sarcoma, a disease with a high unmet need
Presenter: Kan Yonemori
Session: Poster Display session 1
Resources:
Abstract
1511 - A pilot study of oral paclitaxel (ORAXOL) in subjects with cutaneous angiosarcomas (KX-ORAX-010)
Presenter: Herbert Loong
Session: Poster Display session 1
Resources:
Abstract