Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.SEQUOIA (ClinicalTrials.gov identifier: NCT03336333) is a phase III, randomized, open-label trial that compared the oral Bruton tyrosine kinase inhibitor zanubrutinib to bendamustine plus rituximab (BR) in treatment-naïve patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The initial prespecified analysis (median follow-up, 26.2 months) and subsequent analysis (43.7 months) found superior progression-free survival (PFS; the primary end point) in patients who received zanubrutinib compared with BR. At a median follow-up of 61.2 months, median PFS was not reached in zanubrutinib-treated patients; median PFS was 44.1 months in BR-treated patients (hazard ratio [HR], 0.29; one-sided P = .0001). Prolonged PFS was seen with zanubrutinib versus BR in patients with mutated immunoglobulin heavy-chain variable region (IGHV) genes (HR, 0.40; one-sided P = .0003) and unmutated IGHV genes (HR, 0.21 [95% CI, 0.14 to 0.33]; one-sided P < .0001). Median overall survival (OS) was not reached in either treatment arm; estimated 60-month OS rates were 85.8% and 85.0% in zanubrutinib- and BR-treated patients, respectively. No new safety signals were detected. Adverse events were as expected with zanubrutinib; rate of atrial fibrillation was 7.1%. At a median follow-up of 61.2 months, the results supported the initial SEQUOIA findings and suggested that zanubrutinib was a favorable treatment option for untreated patients with CLL/SLL.
- MeSH
- bendamustin hydrochlorid * aplikace a dávkování terapeutické užití MeSH
- chronická lymfatická leukemie * farmakoterapie mortalita MeSH
- doba přežití bez progrese choroby MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- piperidiny terapeutické užití aplikace a dávkování škodlivé účinky MeSH
- protokoly antitumorózní kombinované chemoterapie * terapeutické užití škodlivé účinky MeSH
- pyrazoly * terapeutické užití aplikace a dávkování škodlivé účinky MeSH
- pyrimidiny * terapeutické užití aplikace a dávkování škodlivé účinky MeSH
- rituximab * aplikace a dávkování terapeutické užití škodlivé účinky MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Názvy látek
- bendamustin hydrochlorid * MeSH
- piperidiny MeSH
- pyrazoly * MeSH
- pyrimidiny * MeSH
- rituximab * MeSH
- zanubrutinib MeSH Prohlížeč
BACKGROUND: This ongoing follow-up study evaluated the persistence of efficacy and immune responses for 6 additional years in adults vaccinated with the glycoprotein E (gE)-based adjuvanted recombinant zoster vaccine (RZV) at age ≥50 years in 2 pivotal efficacy trials (ZOE-50 and ZOE-70). The present interim analysis was performed after ≥2 additional years of follow-up (between 5.1 and 7.1 years [mean] post-vaccination) and includes partial data for year (Y) 8 post-vaccination. METHODS: Annual assessments were performed for efficacy against herpes zoster (HZ) from Y6 post-vaccination and for anti-gE antibody concentrations and gE-specific CD4[2+] T-cell (expressing ≥2 of 4 assessed activation markers) frequencies from Y5 post-vaccination. RESULTS: Of 7413 participants enrolled for the long-term efficacy assessment, 7277 (mean age at vaccination, 67.2 years), 813, and 108 were included in the cohorts evaluating efficacy, humoral immune responses, and cell-mediated immune responses, respectively. Efficacy of RZV against HZ through this interim analysis was 84.0% (95% confidence interval [CI], 75.9-89.8) from the start of this follow-up study and 90.9% (95% CI, 88.2-93.2) from vaccination in ZOE-50/70. Annual vaccine efficacy estimates were >84% for each year since vaccination and remained stable through this interim analysis. Anti-gE antibody geometric mean concentrations and median frequencies of gE-specific CD4[2+] T cells reached a plateau at approximately 6-fold above pre-vaccination levels. CONCLUSIONS: Efficacy against HZ and immune responses to RZV remained high, suggesting that the clinical benefit of RZV in older adults is sustained for at least 7 years post-vaccination. Clinical Trials Registration. NCT02723773.
- Klíčová slova
- adjuvanted recombinant zoster vaccine, immune response persistence, long-term efficacy,
- MeSH
- adjuvancia imunologická MeSH
- herpes zoster * prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- senioři MeSH
- syntetické vakcíny MeSH
- vakcína proti pásovému oparu * MeSH
- virus varicella zoster MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- Názvy látek
- adjuvancia imunologická MeSH
- syntetické vakcíny MeSH
- vakcína proti pásovému oparu * MeSH
Citizen science is a growing field of research and practice, generating new knowledge and understanding through the collaboration of citizens in scientific research. As the field expands, it is becoming increasingly important to consider its potential to foster education and learning opportunities. Although progress has been made to support learning in citizen science projects, as well as to facilitate citizen science in formal and informal learning environments, challenges still arise. This paper identifies a number of dilemmas facing the field-from competing scientific goals and learning outcomes, differing underlying ontologies and epistemologies, diverging communication strategies, to clashing values around advocacy and activism. Although such challenges can become barriers to the successful integration of citizen science into mainstream education systems, they also serve as signposts for possible synergies and opportunities. One of the key emerging recommendations is to align educational learning outcomes with citizen science project goals at the planning stage of the project using co-creation approaches to ensure issues of accessibility and inclusivity are paramount throughout the design and implementation of every project. Only then can citizen science realise its true potential to empower citizens to take ownership of their own science education and learning.
- Klíčová slova
- activism, learning environments, ontology and epistemology, public engagement, science communication, teachers,
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH