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Off-label Use of Anti-cancer Drugs in Norway -a Prospective Cohort Study

Recruiting
Conditions
Cancer
Registration Number
NCT04457713
Lead Sponsor
Oslo University Hospital
Brief Summary

Off-label drug use, where a marketed drug is used outside its approved indication, may allow early access to new and promising treatments. However, its use can be a source of controversy, due to limited evidence for clinical benefit and lack of cost/QALY-estimates, leading to challenging prioritization issues. The number of drugs suitable for off-label use is expected to further increase in the coming years, owing to the rapid progress in the field of oncology, in particular with the current era of precision medicine and targeted therapies. This also challenges the traditional method of running clinical trials, with eligible patient populations commonly being small, underpinning the importance of gaining supplementary real-world evidence from well performed observational studies.

This prospective observational study will therefore assess real-world outcomes of patients treated with off-label anti-cancer drugs, including efficacy in terms of response rates, time to progression/relapse measures and survival; patient-reported outcome measures (PROMS) and self-reported side-effects/toxicity; as well as collecting blood samples for a biobank for further translational research. Further, the study will give a descriptive analysis of the current practice of off-label use of anti-cancer drugs in Norway, including prevalence estimation and health care related cost analyses.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Verified cancer diagnosis (based on radiological, histological/cytological or operative evidence).
  • Treatment with off-label anti-cancer drug.
  • Age ≥ 18 years
  • Able to provide written informed consent.
Exclusion Criteria
  • None

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Progression free survival (PFS).Assessed up to 2 years after end of inclusion

Time from date of inclusion until the date of first documented progression or date of death from any cause, whichever come first, according to RECIST v1.1

Patients questionnaire EORTC QLQ-C30Assessed from inclusion until 2 years after end of treatment

Assessment of patients reported quality of life, as measured by EORTC QLC30

Secondary Outcome Measures
NameTimeMethod
Overall survival (OS)Assessed up to 2 years after end of inclusion

Time from date of inclusion until the date of death from any cause

Time to next treatment (TTNT)Assed through study completion, an average of 1 year

Time from inclusion to institution og next therapy

DepressionFrom inclusion until 2 years after end of treatment

Assessment of patient reported outcomes, as measured by the patient health questionnaire (PHQ-9)

Adverse eventFrom inclusion until 2 years after end of treatment

Patients files and self-report. Classified according to CTCAE v 5.0 and MedDRA

Objective tumor response rate (ORR)Assed through study completion, an average of 1 year

Defined as the proportion of patients with an objective tumor response (either partial response \[PR\] or complete response \[CR\] using RECIST v1.1) response (DR), time to next treatment and overall survival (OS)

Duration of response (DR)Assed through study completion, an average of 1 year

Duration of response among patients with an objective response, according to RECIST v1.1

FatigueFrom inclusion until 2 years after end of treatment

Assessment of patient reported outcomes, as measured by the Chalder Fatigue Questionnaire (FQ)

Pain intensityFrom inclusion until 2 years after end of treatment

Assessment of patient reported outcomes, as measured by an 11 point Numerical Rating Scale (NRS) for pain intensity

Quality adjusted life years (QALYs)From inclusion until 2 years after end of treatment

Patient self reported EQ-5D

Trial Locations

Locations (1)

Oslo University Hospital

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Oslo, Norway

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