Fausto Petrelli1, Sandro Barni1. 1. Azienda Ospedaliera Treviglio, Oncology department, Medical oncology unit, Piazzale Ospedale 1, 24047, Treviglio (BG), Italia.
Abstract
BACKGROUND: In advanced non-small cell lung cancer (NSCLC), the increasing number of active compounds available in second line settings makes overall survival (OS) with maintenance treatment a not frequently observed endpoint. A literature review was conducted to examine whether post-progression survival (PPS) correlates with OS in maintenance trials. MATERIALS AND METHODS: PPS was defined as median OS - median PFS. The authors used the coefficient of correlation (r) to assess the correlation between them. They also evaluated the surrogacy of PFS and OS. RESULTS: Ten trials with 11 arms were identified. Overall, a stronger correlation was observed between OS and PPS [Spearman rank correlation coefficient (r) =0.75] than OS and PFS time (r=0.37). The correlation of differences in median PFS (ΔPFS) and median OS (ΔOS) is 0.64 (P=0.0326). The slope of the regression line is 0.76, indicating that a maintenance therapy producing a one-month gain in PFS will yield an estimated three weeks prolongation in OS. CONCLUSIONS: PPS is strongly associated with OS because of intensive post-study further lines of treatment. However, improvements in PFS are moderately associated with improvements in OS. Hence, in this setting, PFS is a possible surrogate for OS.
BACKGROUND: In advanced non-small cell lung cancer (NSCLC), the increasing number of active compounds available in second line settings makes overall survival (OS) with maintenance treatment a not frequently observed endpoint. A literature review was conducted to examine whether post-progression survival (PPS) correlates with OS in maintenance trials. MATERIALS AND METHODS:PPS was defined as median OS - median PFS. The authors used the coefficient of correlation (r) to assess the correlation between them. They also evaluated the surrogacy of PFS and OS. RESULTS: Ten trials with 11 arms were identified. Overall, a stronger correlation was observed between OS and PPS [Spearman rank correlation coefficient (r) =0.75] than OS and PFS time (r=0.37). The correlation of differences in median PFS (ΔPFS) and median OS (ΔOS) is 0.64 (P=0.0326). The slope of the regression line is 0.76, indicating that a maintenance therapy producing a one-month gain in PFS will yield an estimated three weeks prolongation in OS. CONCLUSIONS:PPS is strongly associated with OS because of intensive post-study further lines of treatment. However, improvements in PFS are moderately associated with improvements in OS. Hence, in this setting, PFS is a possible surrogate for OS.
Entities:
Keywords:
Non small cell lung cancer; maintenance therapy; overall survival; post progression survival; progression free survival; surrogate endpoint
Authors: Thomas Brodowicz; Maciej Krzakowski; Matjaz Zwitter; Valentina Tzekova; Rodryg Ramlau; Nicolae Ghilezan; Tudor Ciuleanu; Branka Cucevic; Kalman Gyurkovits; Ernst Ulsperger; Jacek Jassem; Mislav Grgic; Pinar Saip; Maria Szilasi; Christoph Wiltschke; Maria Wagnerova; Natalya Oskina; Victoria Soldatenkova; Christoph Zielinski; Miklos Wenczl Journal: Lung Cancer Date: 2006-03-29 Impact factor: 5.705
Authors: Madhusmita Behera; Taofeek K Owonikoko; Zhengjia Chen; Scott A Kono; Fadlo R Khuri; Chandra P Belani; Suresh S Ramalingam Journal: Lung Cancer Date: 2012-04-28 Impact factor: 5.705
Authors: Panos M Fidias; Shaker R Dakhil; Alan P Lyss; David M Loesch; David M Waterhouse; Jane L Bromund; Ruqin Chen; Maria Hristova-Kazmierski; Joseph Treat; Coleman K Obasaju; Martin Marciniak; John Gill; Joan H Schiller Journal: J Clin Oncol Date: 2008-12-15 Impact factor: 44.544
Authors: S Siena; M Peeters; E Van Cutsem; Y Humblet; P Conte; E Bajetta; D Comandini; G Bodoky; G Van Hazel; T Salek; M Wolf; G Devercelli; M Woolley; R G Amado Journal: Br J Cancer Date: 2007-11-27 Impact factor: 7.640
Authors: Sean Khozin; Rebecca A Miksad; Johan Adami; Mariel Boyd; Nicholas R Brown; Anala Gossai; Irene Kaganman; Deborah Kuk; Jillian M Rockland; Richard Pazdur; Aracelis Z Torres; Jizu Zhi; Amy P Abernethy Journal: Cancer Date: 2019-08-05 Impact factor: 6.860