The choice of an endpoint can really change the way a treatment is administered or approved for use on patients. And in the future, we will see much more data on quality of life, and trials will probably also work on validating surrogate endpoints and biomarkers.

In this TJ Talks dedicated to the hot topic of endpoints in clinical trials, Gabriele Zoppoli, Associate Professor of Medicine at University of Genoa and Internal Medicine Consultant at Policlinico San Martino (Genoa) meet Erman Akkus, MD at Ankara University, Faculty of Medicine, Department of Medical Oncology.

Alongside “primary clinical endpoints”, which concern overall survival and quality of life, surrogate endpoints are early or indirect measures of these primary endpoints, such as progression-free survival and response rate. Their purpose? To facilitate clinical trials and drug approval, but surrogate endpoints are still an active area of research and are the subject of debate in oncology. Meanwhile, patients' perceptions are waiting to be taken more seriously.

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Pharmaco-prevention of breast cancer is an evidence-based strategy that uses drugs to reduce the risk of disease in high-risk women. However, the use of this strategy remains modest due to concerns about toxicity, low awareness and difficulties in patient selection.

In this TJ Talks podcast, together with Prof. Andrea De Censi, director of the Breast Unit at the Champalimaud Foundation in Lisbon, Portugal, here in conversation with Prof. Antonino Musolino (director of the Medical Oncology Unit at the IRCCS-Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”, Meldola, Forlì-Cesena), we will examine what practical solutions can bridge the gap between pharmacological prevention, indication and adoption, with a look at the future perspectives in this setting.

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Stories of foreign cancer patients who ask to return to their country at the end of their lives: their deep desire to see their loved ones one last time is intertwined with medical, legal and financial issues that seem insurmountable. In this TJ Talks, Dr Sergio Defendi, director of Palliative Care and Home Care at Asst Crema, who has been providing assistance with end-of-life travel for years, discusses this issue together with Dr Luca Zambelli, from the Palliative Care Unit of the IRCCS National Cancer Institute Foundation in Milan.

How should the responsibility for end-of-life repatriation be managed? Clinical uncertainty, the legal issue of the use of certain drugs, and the protection of patients and accompanying doctors should be addressed in guidelines or care pathways that deal with this sensitive issue. This is the next challenge for the oncology community.

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