Association Between Progression-Free Survival and Overall Survival in Mantle Cell Lymphoma: A Trial-level Surrogate Endpoint Analysis.

What was studied

This systematic review asked if progression-free survival (PFS) can stand in for overall survival (OS). The setting was trials in mantle cell lymphoma. Trials often use PFS as the main goal to save time and cost. The team searched for late-stage trials in this disease. They compared treatment effects on PFS and OS with a regression method. They also worked out the PFS gain needed to predict a gain in OS.

What they found

The review included trials with 19 treatment comparisons and 5996 patients. The link between effects on PFS and OS had an R2 of 0.75. The authors call this a moderate association. For an average-sized trial of 334 patients, the threshold effect was 0.59. Both outcomes showed a significant benefit in only some comparisons.

What it means for patients

The authors conclude that PFS has a moderate link with OS. They say a large PFS gain is needed to predict an OS gain. This limits how far PFS can be trusted as a stand-in. They note this is true especially when treatment effects are modest.

Why it is not certain yet

A review can only be as good as the studies in it. The abstract does not rate the quality of the trials. A moderate link means PFS does not always predict OS. The abstract does not say which treatments were compared.

Source

Association Between Progression-Free Survival and Overall Survival in Mantle Cell Lymphoma: A Trial-level Surrogate Endpoint Analysis.

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