Post-Progression Survival Associated with Overall Survival in Patients with Advanced Non-Small-Cell Lung Cancer Receiving Docetaxel Monotherapy as Second-Line Chemotherapy

Kotake, Mie; Miura, Yoshiko; Imai, Hisao; Mori, Keita; Sakurai, Reiko; Kaira, Kyoichi; Tomizawa, Yoshio; Minato, Koichi; Saito, Ryusei; Hisada, Takeshi

doi:10.1159/000456534

Cited by 10 publications

(19 citation statements)

References 38 publications

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“…In contrast with the findings of previous studies, some reports of individual levels did not find PFS to be a surrogate endpoint for OS in advanced lung cancer patients, although PPS was not evaluated in those studies. These reports found that PFS was much shorter than PPS.…”

Section: Clinical Significance Of Post‐progression Survival (Pps)contrasting

confidence: 86%

“…These reports found that PFS was much shorter than PPS. Thus, PPS was closely related to OS – in fact, the relationship was linear . The fact that PPS accounted for the majority of OS suggests that the chemotherapy used was not sufficiently effective for PFS to be a significant component of OS.…”

Section: Clinical Significance Of Post‐progression Survival (Pps)mentioning

confidence: 98%

“…The use of individual patient data might allow better characterization of the relationship between OS and other endpoints based on tumor assessment, including PFS and PPS. Recently, the significance of PPS after first and second‐line therapy at the individual level in patients with advanced lung cancer has been reported . Although there have been reports about PPS after EGFR‐TKI and ALK‐TKI treatment at the individual level in patients with advanced EGFR‐mutated and ALK rearrangement positive NSCLC, those reports did not address the correlation between OS and PFS or PPS .…”

Section: Clinical Significance Of Post‐progression Survival (Pps)mentioning

confidence: 99%

“…In multivariate Cox regression analysis, studies of first‐line treatment based on individual advanced non‐squamous NSCLC with unknown oncogenic driver mutations revealed that long PPS was associated with performance status (PS) at the beginning of second‐line treatment, the best response at the second‐line treatment, and the number of regimens after progression beyond first‐line chemotherapy . Studies of second‐line treatment based on individual advanced non‐squamous NSCLC with unknown oncogenic driver mutations revealed that long PPS was associated with the PS at the end of second‐line treatment, the best response at the third‐line treatment, and the number of regimens after progression beyond second‐line chemotherapy . Studies of first‐line treatment based on individual patients with advanced NSCLC harboring sensitive EGFR gene mutations revealed that long PPS was associated with the best response at second‐line treatment, and the number of regimens after progression beyond first‐line chemotherapy .…”

Section: Clinical Significance Of Post‐progression Survival (Pps)mentioning

confidence: 99%

“…Previous reports have shown that PPS after first and second‐line chemotherapy for advanced gastric cancer and after third‐line chemotherapy for metastatic breast cancer highly correlated with OS at the individual level . The significance of PPS after first and second‐line therapy at the individual level in patients with advanced lung cancer has also been reported . Therefore, an overview of PPS after early‐line therapy in patients with cancer using individual‐level data might be of clinical importance.…”

Section: Introductionmentioning

confidence: 99%

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Clinical significance of post‐progression survival in lung cancer

2017

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Progression‐free survival (PFS) and overall survival (OS) are two common endpoints in cancer trials. OS is usually preferred, because it is reliable, precise, meaningful, and can easily be documented. However, subsequent lines of therapy might confound the effects of first‐line treatment on OS. Whether PFS or OS is the more appropriate endpoint in clinical trials of metastatic cancer remains controversial. Previous reports on lung cancer have shown that an increase in PFS does not necessarily result in an increase in OS; however, post‐progression survival (PPS) is strongly associated with OS after early‐line treatment. The significance of PPS after first and second‐line therapy at the individual level in patients with advanced lung cancer has also recently been reported. Findings of previous reports indicate that PPS is highly associated with OS after first and second‐line chemotherapy in patients with advanced non‐small cell lung cancer and small cell lung cancer, whereas PFS is only moderately associated with OS. Therefore, subsequent treatment after disease progression following early‐line treatments may greatly influence OS. This review demonstrates that even in advanced lung cancer, PPS, rather than PFS, has become more strongly associated with OS over the years, potentially because of intensive post‐study treatments. As a result of the increasing impact of PPS on OS, a PFS‐related advantage does not necessarily indicate an OS‐related advantage. Thus, the prolongation of PPS might limit the classical role of OS for assessing true efficacy derived from early‐line chemotherapy in future clinical trials.

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Section: Clinical Significance Of Post‐progression Survival (Pps)contrasting

confidence: 86%

Section: Clinical Significance Of Post‐progression Survival (Pps)mentioning

confidence: 98%

Section: Clinical Significance Of Post‐progression Survival (Pps)mentioning

confidence: 99%

Section: Clinical Significance Of Post‐progression Survival (Pps)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical significance of post‐progression survival in lung cancer

2017

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Sintilimab versus docetaxel as second‐line treatment in advanced or metastatic squamous non‐small‐cell lung cancer: an open‐label, randomized controlled phase 3 trial (ORIENT‐3)

Shi

et al. 2022

Cancer Communications

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The effect of post-progression survival on overall survival among patients with sensitive relapse of small cell lung cancer

et al. 2018

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Recent studies have suggested that, among patients with advanced lung cancer, subsequent treatment after failure of first-line or second-line chemotherapy has a greater effect on overall survival (OS) than tumor shrinkage or progression-free survival (PFS). However, no studies have examined this issue among patients with sensitive relapse of small cell lung cancer (SCLC). We retrospectively evaluate 77 patients with sensitive relapse of SCLC who received second-line chemotherapy after first-line platinum doublet chemotherapy between January 1999 and November 2013. The analyses included patient characteristics, treatment parameters, tumor shrinkage, PFS, post-progression survival (PPS), and OS. Spearman rank correlation analysis and linear regression analysis revealed that PPS was strongly correlated with OS (r = 0.91, p < 0.01, R = 0.96), PFS was moderately correlated with OS (r = 0.58, p < 0.01, R = 0.28), and tumor shrinkage was weakly correlated with OS (r = 0.34, p < 0.01, R = 0.12). A multivariate Cox proportional hazards model with a stepwise regression procedure revealed that PPS was significantly associated with age at the start of second-line chemotherapy, best response to second-line and third-line chemotherapy, and the number of regimens after progression beyond second-line chemotherapy (p < 0.05). These findings suggest that PPS has a stronger effect than PFS on OS among patients with sensitive relapse of SCLC. Thus, response to second-line chemotherapy and subsequent treatment for disease progression after second-line chemotherapy may be important factors that influence OS.

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Post-Progression Survival Associated with Overall Survival in Patients with Advanced Non-Small-Cell Lung Cancer Receiving Docetaxel Monotherapy as Second-Line Chemotherapy

Cited by 10 publications

References 38 publications

Clinical significance of post‐progression survival in lung cancer

Clinical significance of post‐progression survival in lung cancer

Sintilimab versus docetaxel as second‐line treatment in advanced or metastatic squamous non‐small‐cell lung cancer: an open‐label, randomized controlled phase 3 trial (ORIENT‐3)

The effect of post-progression survival on overall survival among patients with sensitive relapse of small cell lung cancer

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