期刊
LUNG CANCER
卷 79, 期 1, 页码 20-26出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2012.10.007
关键词
Non-small-cell lung cancer; Overall survival; Surrogate marker; Progression-free survival
Background: We examined how crossover therapy might affect the association between progression-free survival (PFS) and overall survival (OS) in non-small cell lung cancer (NSCLC). Methods: We extracted PFS- and OS-hazard ratios (HRs) in phase III trials of molecular-targeted agents for advanced NSCLC. Their relationship was modeled in a linear function with the coefficient of determination (R-squared) to assess the correlation between PFS and OS. Results: Thirty-four trials with 35 pairs for the investigational and reference arms were identified (24,158 patients). Overall, there was little correlation between PFS- and OS-HRs (R-squared = 0.14), suggesting PFS-HR could account only for 14% of variation in OS-HR The median proportion of crossover therapy per trial was 20%. If patients seldom crossed over (none or <1%), the association between PFS- and OS-HRs was strong (R-squared = 0.69). When the proportion of crossover was >= 1%, however, R-squared declined considerably (>= 1% to <20% crossover, R-squared = 0.27; >= 20% to <40%, R-squared = 0.06; and >= 40%, R-squared = 0.27). Conclusions: A PFS advantage seldom is associated with an OS advantage any longer. Our analysis suggests this is due to a high level of crossover now that an increasing number of active agents are available for NSCLC. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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