Systematic Review and Meta-Analysis of Correlation of Progression-Free Survival-2 and Overall Survival in Solid Tumors

Abstract

Background: Using progression-free survival (PFS)2, time from randomization to 2nd disease progression or death, is proposed as a surrogate for overall survival (OS) in oncology clinical trials. We used published data from solid tumor trials to assess whether PFS2 and OS are correlated. Methods: A literature search identified studies that reported PFS, PFS2, and OS. Two reviewers screened for eligibility, and documented PFS2, PFS or time from 1st to 2nd disease progression or death and OS. Correlation between PFS2 and OS was assessed using: (1) Kendall's Tau + Pearson's correlation coefficient in randomized controlled trials (RCTs); (2) Meta-analysis with the random effects model to compute the pooled correlation of PFS2 and OS. Results: Overall, 133 studies met search criteria, 15 (28 arms) had complete PFS2 and OS data in ovarian, gastric, colorectal, prostate, lung, renal and breast cancers. A positive correlation for PFS2 and OS was found for all 15 studies (Kendall's Tau = 0.7 [95% CIs 0.54, 0.78]); 10 RCTs (Pearson's correlation coefficient = 0.86); and metaanalysis from 7 trials (pooled Spearman's correlation coefficient = 0.84 [p = 0.0001; 95% CIs 0.71, 0.96]). Conclusions: In this retrospective analysis PFS2 strongly correlates with OS supporting the use of PFS2 to measure long-term clinical benefit when OS cannot be assessed.

[Retracted] Construction and Drug Evaluation Based on Convolutional Neural Network System Optimized by Grey Correlation Analysis

“…In recent years, with the development of society, people's demand for spiritual life is increasing, the incidence of mental illness is also increasing year by year, and the incidence is mostly concentrated in big cities [ 11 – 13 ]. Modern medicine has a huge amount of complex data; in many cases, it is difficult to achieve a reasonable allocation of resources, which puts forward an urgent demand for the artificial intelligence of modern medicine and also brings great pressure to the development of the medical industry [ 14 – 16 ]. Compared with other kinds of diseases, the medical data of mental diseases may have more complex data records, which consumes a lot of medical human resources.…”

A real‐world comparison of docetaxel versus abiraterone acetate for metastatic hormone‐sensitive prostate cancer

“…The impact of subsequent treatments may hide the effect of the first‐line treatment such that OS benefits are not always observed despite significant improvements in PFS. 22 Also imaginable is the scenario in which first‐line therapies may have a short PFS but extend OS by sensitizing tumor cells to second‐line agents. 23 In the current investigation, 69.6% of progressing males received D in the AA+ADT group as compared to 70.8% of those from the D+ADT group who received SHT upon progression.…”

“… 24 In a contemporary meta‐analysis of 15 studies on different tumor entities including PCa, Chowdhury and colleagues demonstrated that PFS2 strongly correlated with OS proposing its usage before OS data get mature or if OS cannot be assessed. 22 Using the data of the PROREPAIR‐B study which investigated the impact of germline DNA repair mutations on the outcomes of patients with mCRPC, 25 Lorente and coauthors observed that PFS2 outperformed PFS1 as a predictor of OS. Since the number of events during the second‐line treatment in our analysis was low precluding far‐reaching conclusions, further research is warranted to shed light on the influence of both AA+ADT and D+ADT on PFS2.…”

“…Theoretically, relationship between PFS and OS may be considerably influenced by subsequent therapies, particularly by the second‐line treatment. The impact of subsequent treatments may hide the effect of the first‐line treatment such that OS benefits are not always observed despite significant improvements in PFS 22 . Also imaginable is the scenario in which first‐line therapies may have a short PFS but extend OS by sensitizing tumor cells to second‐line agents 23 .…”

The “Great Debate” at Immunotherapy Bridge 2020, December 3rd, 2020

“…One option that has been proposed is to consider time from randomization to second disease progression (PFS2). A meta-analysis showed a positive correlation for PFS2 and OS was found for all 15 studies that reported both endpoints, supporting the use of PFS2 to measure long-term clinical benefit when OS cannot be assessed [ 33 ]. However, in practice time to second progression may be difficult to monitor in a clinical trial.…”