title: Clinical trial risk in Non-Hodgkin's lymphoma: endpoint and target selection.
abstract: OBJECTIVE
  To quantify the clinical trial risk of new drug development in Non-Hodgkin's lymphoma (NHL). Risk estimates for this disease have not been reported before.
  
  
  METHODS
  We undertook a retrospective review of clinical trials in (NHL) in four subtypes to compare the success rate with the industry average. Our inclusion criteria required that a drug must initiate its phase I trial in one of the four NHL subtypes between 1998 and June 2008 in the US. In addition, clinical trials of new drug candidates that pertain to four subtypes of NHL were retrieved from clinicaltrial.gov. Drug candidates that did not meet these criteria were excluded from the study.
  
  
  RESULTS
  The overall success rate (8-11%) was significantly lower than the industry standard (17%). Overall survival (OS) as a secondary outcome appeared more predictive than primary endpoints that were surrogate, of overall success. Further, targeted therapies appear more successful in these lymphoma sub-types than broad acting drugs.
  
  
  CONCLUSIONS
  Clinical trial risk in NHL, with an 89% failure rate reported here, may be reduced by basing decisions on OS secondary endpoints and biologic drugs.
authors: Biology Department, Master of Biotechnology Program, University of Toronto, Toronto, ON. jayson.parker@utoronto.ca
authors: Jayson L
authors: JL
authors: Parker
authors: Zoe Yi
authors: ZY
authors: Zhang
authors: Rena
authors: R
authors: Buckstein
mesh_terms: D001688:Biological Products / Q000627:therapeutic use; D001709:Biotechnology; D002986:Clinical Trials as Topic / Q000379:methods*; D017321:Clinical Trials, Phase I as Topic / Q000379:methods; D017322:Clinical Trials, Phase II as Topic / Q000379:methods; D017326:Clinical Trials, Phase III as Topic / Q000379:methods; D018572:Disease-Free Survival; D017277:Drug Approval; D004345:Drug Industry; D004358:Drug Therapy; D023381:Endpoint Determination / Q000379:methods*; D006801:Humans; D007167:Immunotherapy; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D017211:Treatment Failure
chemical_list: D001688:Biological Products