Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review

Background: Evidence from observational studies is increasingly used in oncology to complement evidence from clinical trials. Commonly used endpoints to evaluate oncology medicines are overall survival (OS) and progression-free survival (PFS). However, comparing PFS across observational studies and...

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Main Authors: M.V. Verschueren, V.P. Tassopoulou, R. Visscher, J. Schuurkamp, B.J.M. Peters, M. Koopman, E.M.W. van de Garde, A.C.G. Egberts, L.T. Bloem
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Language:English
Published: Elsevier 2025-03-01
Series:ESMO Real World Data and Digital Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949820125000074
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author M.V. Verschueren
V.P. Tassopoulou
R. Visscher
J. Schuurkamp
B.J.M. Peters
M. Koopman
E.M.W. van de Garde
A.C.G. Egberts
L.T. Bloem
author_facet M.V. Verschueren
V.P. Tassopoulou
R. Visscher
J. Schuurkamp
B.J.M. Peters
M. Koopman
E.M.W. van de Garde
A.C.G. Egberts
L.T. Bloem
author_sort M.V. Verschueren
collection DOAJ
description Background: Evidence from observational studies is increasingly used in oncology to complement evidence from clinical trials. Commonly used endpoints to evaluate oncology medicines are overall survival (OS) and progression-free survival (PFS). However, comparing PFS across observational studies and with clinical trials can be challenging due to differences in its definition and measurement. This scoping review investigated how PFS was defined, measured, and reported in randomized clinical trials (RCTs) and observational studies of patients with advanced non-small-cell lung cancer (NSCLC) treated with immunotherapy. Materials and methods: This scoping review included RCTs and observational studies that measured PFS in advanced NSCLC patients treated with immunotherapy. ASReview, an open-source artificial intelligence-assisted tool, was used to screen and prioritize relevant studies from records identified from PubMed and Embase between 2012 and 2023. Information on study characteristics, PFS definitions, and measurements was extracted. Results: Forty RCTs and 144 observational studies were included. Most RCTs were conducted across multiple continents (70%), while most observational studies were conducted in Asia (62%). In contrast to RCTs, many observational studies lacked reporting on the end date of PFS measurement (69%), the type of radiological imaging (59%), and the imaging reviewer (78%). For observational studies that did report on PFS definitions and measurements, these often differed from those in RCTs, particularly regarding event definitions, the start and stop dates for PFS measurement, and tumor assessment schedules. Conclusions: In contrast to RCTs, observational studies often lack reporting on PFS definitions and measurements, and if reported, they differ across observational studies and between them and RCTs. Since observational studies are important for complementing evidence, aligning PFS definition and measurement criteria with those used in RCTs, along with detailed reporting, is needed. However, some variability in PFS measurement characteristics is unavoidable, and therefore, PFS estimates from observational studies should be interpreted critically and carefully.
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spelling doaj-art-2915f2278726435e8d10e43100ed9d9d2025-08-20T02:19:23ZengElsevierESMO Real World Data and Digital Oncology2949-82012025-03-01710011810.1016/j.esmorw.2025.100118Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping reviewM.V. Verschueren0V.P. Tassopoulou1R. Visscher2J. Schuurkamp3B.J.M. Peters4M. Koopman5E.M.W. van de Garde6A.C.G. Egberts7L.T. Bloem8Department of Clinical Pharmacy, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The NetherlandsDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The NetherlandsDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The NetherlandsDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The NetherlandsDepartment of Clinical Pharmacy, St. Antonius Hospital, Utrecht/Nieuwegein, The NetherlandsDepartment of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Clinical Pharmacy, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The NetherlandsDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, The NetherlandsDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; Correspondence to: Dr L. T. Bloem, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands. Tel: +31-683392346Background: Evidence from observational studies is increasingly used in oncology to complement evidence from clinical trials. Commonly used endpoints to evaluate oncology medicines are overall survival (OS) and progression-free survival (PFS). However, comparing PFS across observational studies and with clinical trials can be challenging due to differences in its definition and measurement. This scoping review investigated how PFS was defined, measured, and reported in randomized clinical trials (RCTs) and observational studies of patients with advanced non-small-cell lung cancer (NSCLC) treated with immunotherapy. Materials and methods: This scoping review included RCTs and observational studies that measured PFS in advanced NSCLC patients treated with immunotherapy. ASReview, an open-source artificial intelligence-assisted tool, was used to screen and prioritize relevant studies from records identified from PubMed and Embase between 2012 and 2023. Information on study characteristics, PFS definitions, and measurements was extracted. Results: Forty RCTs and 144 observational studies were included. Most RCTs were conducted across multiple continents (70%), while most observational studies were conducted in Asia (62%). In contrast to RCTs, many observational studies lacked reporting on the end date of PFS measurement (69%), the type of radiological imaging (59%), and the imaging reviewer (78%). For observational studies that did report on PFS definitions and measurements, these often differed from those in RCTs, particularly regarding event definitions, the start and stop dates for PFS measurement, and tumor assessment schedules. Conclusions: In contrast to RCTs, observational studies often lack reporting on PFS definitions and measurements, and if reported, they differ across observational studies and between them and RCTs. Since observational studies are important for complementing evidence, aligning PFS definition and measurement criteria with those used in RCTs, along with detailed reporting, is needed. However, some variability in PFS measurement characteristics is unavoidable, and therefore, PFS estimates from observational studies should be interpreted critically and carefully.http://www.sciencedirect.com/science/article/pii/S2949820125000074progression-free survivalobservational studiesrandomized clinical trialsadvanced non-small-cell lung cancerimmunotherapyscoping review
spellingShingle M.V. Verschueren
V.P. Tassopoulou
R. Visscher
J. Schuurkamp
B.J.M. Peters
M. Koopman
E.M.W. van de Garde
A.C.G. Egberts
L.T. Bloem
Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review
ESMO Real World Data and Digital Oncology
progression-free survival
observational studies
randomized clinical trials
advanced non-small-cell lung cancer
immunotherapy
scoping review
title Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review
title_full Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review
title_fullStr Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review
title_full_unstemmed Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review
title_short Definitions, measurement, and reporting of progression-free survival in randomized clinical trials and observational studies of patients with advanced non-small-cell lung cancer treated with immunotherapy: a scoping review
title_sort definitions measurement and reporting of progression free survival in randomized clinical trials and observational studies of patients with advanced non small cell lung cancer treated with immunotherapy a scoping review
topic progression-free survival
observational studies
randomized clinical trials
advanced non-small-cell lung cancer
immunotherapy
scoping review
url http://www.sciencedirect.com/science/article/pii/S2949820125000074
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