BACKGROUND: The increased availability of active agents has improved overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC). We previously showed that postprogression survival (PPS) is highly associated with OS in the first-line setting, but little is known about PPS in the salvage setting. In this study, we analyzed PPS in phase III trials in the second-line or third-line setting. PATIENTS AND METHODS: A literature search identified 18 trials for previously treated patients with advanced NSCLC. We partitioned OS into progression-free survival (PFS) and PPS and evaluated the association between OS and either PFS or PPS. Correlation analysis to examine whether a treatment benefit for PFS carried over to OS was performed by calculation of incremental gains in OS and PFS at the trial level. RESULTS: The average median PPS was longer than the average median PFS (5.4 and 2.6 months, respectively). The induction rate for subsequent chemotherapy after second-line or third-line treatment was related to the duration of PPS in linear regression analysis (r(2) = 0.4813). Median OS was highly associated with median PPS but not with PFS (r = 0.94 and 0.51, respectively), and only a weak association between the treatment benefits for PFS and OS was detected (r = 0.29). CONCLUSIONS: Treatment benefit for OS in patients with advanced NSCLC can be skewed by the effects of subsequent therapies in the second-line or third-line setting. Whether PFS or OS is the more appropriate endpoint for trials in the salvage setting should be considered.
BACKGROUND: The increased availability of active agents has improved overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC). We previously showed that postprogression survival (PPS) is highly associated with OS in the first-line setting, but little is known about PPS in the salvage setting. In this study, we analyzed PPS in phase III trials in the second-line or third-line setting. PATIENTS AND METHODS: A literature search identified 18 trials for previously treated patients with advanced NSCLC. We partitioned OS into progression-free survival (PFS) and PPS and evaluated the association between OS and either PFS or PPS. Correlation analysis to examine whether a treatment benefit for PFS carried over to OS was performed by calculation of incremental gains in OS and PFS at the trial level. RESULTS: The average median PPS was longer than the average median PFS (5.4 and 2.6 months, respectively). The induction rate for subsequent chemotherapy after second-line or third-line treatment was related to the duration of PPS in linear regression analysis (r(2) = 0.4813). Median OS was highly associated with median PPS but not with PFS (r = 0.94 and 0.51, respectively), and only a weak association between the treatment benefits for PFS and OS was detected (r = 0.29). CONCLUSIONS: Treatment benefit for OS in patients with advanced NSCLC can be skewed by the effects of subsequent therapies in the second-line or third-line setting. Whether PFS or OS is the more appropriate endpoint for trials in the salvage setting should be considered.
Authors: Manuel de la Torre-Aláez; Carlota Jordán-Iborra; Andrea Casadei-Gardini; José Ignacio Bilbao; Macarena Rodriguez-Fraile; Lidia Sancho; Delia D'Avola; José Ignacio Herrero; Mercedes Iñarrairaegui; Bruno Sangro Journal: Cardiovasc Intervent Radiol Date: 2020-03-12 Impact factor: 2.740
Authors: Angel Alsina; Masatoshi Kudo; Arndt Vogel; Ann-Lii Cheng; Won Young Tak; Baek-Yeol Ryoo; Thomas R Jeffry Evans; Carlos López López; Bruno Daniele; Soamnauth Misir; Min Ren; Namiki Izumi; Shukui Qin; Richard S Finn Journal: Liver Cancer Date: 2019-12-16 Impact factor: 11.740
Authors: David S Hong; Marwan G Fakih; John H Strickler; Jayesh Desai; Gregory A Durm; Geoffrey I Shapiro; Gerald S Falchook; Timothy J Price; Adrian Sacher; Crystal S Denlinger; Yung-Jue Bang; Grace K Dy; John C Krauss; Yasutoshi Kuboki; James C Kuo; Andrew L Coveler; Keunchil Park; Tae Won Kim; Fabrice Barlesi; Pamela N Munster; Suresh S Ramalingam; Timothy F Burns; Funda Meric-Bernstam; Haby Henary; Jude Ngang; Gataree Ngarmchamnanrith; June Kim; Brett E Houk; Jude Canon; J Russell Lipford; Gregory Friberg; Piro Lito; Ramaswamy Govindan; Bob T Li Journal: N Engl J Med Date: 2020-09-20 Impact factor: 176.079