Irreconcilable Differences: The Divorce Between Response Rates, Progression-Free Survival, and Overall Survival
Cet article analyse la corrélation entre taux de réponse au traitement, survie sans progression et survie globale
Oncology drug development has benefited from the ability in many cases to directly measure disease burden by clinical and radiographic measures. Tumor-based end points including objective response rate (ORR) and progression-free survival (PFS) have been implemented as early clinical end points and have been extensively used in the evaluation of anticancer agents. However, recent oncology trials have highlighted a lack of correlation between these early efficacy end points and overall survival (OS). Six randomized controlled trials (RCTs) in either non-Hodgkin lymphomas (NHLs) or chronic lymphocytic leukemia (CLL) that demonstrated PFS improvements were associated with potential detriments in OS.1-4 Similarly, three trials in recurrent ovarian cancer with initial PFS benefit were associated with potential OS detriment with longer follow-up.5-8 Moreover, several immunotherapy trials demonstrated improvements in OS without improvements in PFS and/or ORR.9
Journal of Clinical Oncology , article en libre accès, 2022