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dc.contributor.authorGoodman, Phyllis J.
dc.contributor.authorTangen, Catherine M.
dc.contributor.authorDarke, Amy K.
dc.contributor.authorArnold, Kathryn B.
dc.contributor.authorHartline, JoAnn
dc.contributor.authorYee, Monica
dc.contributor.authorAnderson, Karen
dc.contributor.authorCaban-Holt, Allison
dc.contributor.authorChristen, William G.
dc.contributor.authorCassano, Patricia A.
dc.contributor.authorLance, Peter
dc.contributor.authorKlein, Eric A.
dc.contributor.authorCrowley, John J.
dc.contributor.authorMinasian, Lori M.
dc.contributor.authorMeyskens, Frank L.
dc.date.accessioned2016-11-03T23:16:33Z
dc.date.available2016-11-03T23:16:33Z
dc.date.issued2016-08-12
dc.identifier.citationGoodman et al. Trials (2016) 17:400en
dc.identifier.issn1745-6215
dc.identifier.pmid27519183
dc.identifier.doi10.1186/s13063-016-1524-9
dc.identifier.urihttp://hdl.handle.net/10150/621277
dc.description.abstractBackground: The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a randomized, double-blind, placebo-controlled, prostate cancer prevention study funded by the National Cancer Institute and conducted by SWOG (Southwest Oncology Group). A total of 35,533 men were assigned randomly to one of four treatment groups (vitamin E + placebo, selenium + placebo, vitamin E + selenium, placebo + placebo). At the time of the trial's development, NIH had invested substantial resources in evaluating the potential benefits of these antioxidants. To capitalize on the knowledge gained from following a large cohort of healthy, aging males on the effects of selenium and/or vitamin E, ancillary studies with other disease endpoints were solicited. Methods: Four ancillary studies were added. Each drew from the same population but had independent objectives and an endpoint other than prostate cancer. These studies fell into two categories: those prospectively enrolling and following participants (studies of Alzheimer's disease and respiratory function) and those requiring a retrospective medical record review after a reported event (cataracts/age-related macular degeneration and colorectal screening). An examination of the challenges and opportunities of adding ancillary studies is provided. The impact of the ancillary studies on adherence to SELECT was evaluated using a Cox proportional hazards model. Results: While the addition of ancillary studies appears to have improved participant adherence to the primary trial, this did not come without added complexity. Activation of the ancillary studies happened after the SELECT randomizations had begun resulting in accrual problems to some of the studies. Study site participation in the ancillary trials varied greatly and depended on the interest of the study site principal investigator. Procedures for each were integrated into the primary trial and all monitoring was done by the SELECT Data and Safety Monitoring Committee. The impact of the early closure of the primary trial was different for each of the ancillary trials. Conclusions: The ancillary studies allowed study sites to broaden the research opportunities for their participants. Their implementation was efficient because of the established infrastructure of the primary trial. Implementation of these ancillary trials took substantial planning and coordination but enriched the overall primary trial.
dc.description.sponsorshipPublic Health Service - National Cancer Institute, National Institutes of Health, Department of Health and Human Services [CA37429, UM1 CA182883]; National Center for Complementary and Alternative Medicine (National Institutes of Health); NIA [R01 AG19241]; NEI [EY014418]; NHLBI [RO1HL071022]; NCI [R01CA124862]en
dc.language.isoenen
dc.publisherBioMed Central Ltden
dc.relation.urlhttps://trialsjournal.biomedcentral.com/articles/10.1186/s13063-016-1524-9en
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).en
dc.subjectProstate canceren
dc.subjectAncillary studiesen
dc.subjectRandomized controlled trialen
dc.subjectStudy implementationen
dc.titleOpportunities and challenges in incorporating ancillary studies into a cancer prevention randomized clinical trialen
dc.typeArticleen
dc.contributor.departmentUniv Arizona, Arizona Canc Ctren
dc.identifier.journalTrialsen
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
dc.internal.reviewer-noteAmanda, this one's for you!en
refterms.dateFOA2018-06-23T20:32:55Z
html.description.abstractBackground: The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a randomized, double-blind, placebo-controlled, prostate cancer prevention study funded by the National Cancer Institute and conducted by SWOG (Southwest Oncology Group). A total of 35,533 men were assigned randomly to one of four treatment groups (vitamin E + placebo, selenium + placebo, vitamin E + selenium, placebo + placebo). At the time of the trial's development, NIH had invested substantial resources in evaluating the potential benefits of these antioxidants. To capitalize on the knowledge gained from following a large cohort of healthy, aging males on the effects of selenium and/or vitamin E, ancillary studies with other disease endpoints were solicited. Methods: Four ancillary studies were added. Each drew from the same population but had independent objectives and an endpoint other than prostate cancer. These studies fell into two categories: those prospectively enrolling and following participants (studies of Alzheimer's disease and respiratory function) and those requiring a retrospective medical record review after a reported event (cataracts/age-related macular degeneration and colorectal screening). An examination of the challenges and opportunities of adding ancillary studies is provided. The impact of the ancillary studies on adherence to SELECT was evaluated using a Cox proportional hazards model. Results: While the addition of ancillary studies appears to have improved participant adherence to the primary trial, this did not come without added complexity. Activation of the ancillary studies happened after the SELECT randomizations had begun resulting in accrual problems to some of the studies. Study site participation in the ancillary trials varied greatly and depended on the interest of the study site principal investigator. Procedures for each were integrated into the primary trial and all monitoring was done by the SELECT Data and Safety Monitoring Committee. The impact of the early closure of the primary trial was different for each of the ancillary trials. Conclusions: The ancillary studies allowed study sites to broaden the research opportunities for their participants. Their implementation was efficient because of the established infrastructure of the primary trial. Implementation of these ancillary trials took substantial planning and coordination but enriched the overall primary trial.


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