Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer

Abstract Purpose New treatment strategies, particularly the introduction of molecular-targeted agents and appropriate patient selection based on histology and/or genotyping, have progressed markedly in recent years, and the overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patient...

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Main Authors: Masayuki Aboshi, Masayuki Kaneko, Mamoru Narukawa
Format: Article
Language:English
Published: Springer 2014-02-01
Series:Journal of Cancer Research and Clinical Oncology
Subjects:
Online Access:https://doi.org/10.1007/s00432-014-1617-3
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author Masayuki Aboshi
Masayuki Kaneko
Mamoru Narukawa
author_facet Masayuki Aboshi
Masayuki Kaneko
Mamoru Narukawa
author_sort Masayuki Aboshi
collection DOAJ
description Abstract Purpose New treatment strategies, particularly the introduction of molecular-targeted agents and appropriate patient selection based on histology and/or genotyping, have progressed markedly in recent years, and the overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients has improved. The aim of the study was to identify factors affecting longer OS than that estimated from progression-free survival (PFS) in first-line treatment for advanced NSCLC. Methods Sixty-five controlled trials for first-line treatment of advanced NSCLC were extracted for the study. Factors influencing higher than predicted OS were examined by logistic regression analysis between the OS-extended group and the OS-association group. Results PFS was moderately associated with OS. Twenty arms of 14 trials were categorized as an OS-extended group, in which the ratio of observed OS to estimated OS was found to be over 1.2. On multivariate logistic regression analysis, number of patients lower than 150, average age younger than 63 years, and percentage of squamous carcinoma <30 % were found to significantly affect this relationship. Conclusion We identified number of patients and well-known prognostic factors including age and histological cancer type as factors influencing longer OS. These factors should be considered for patient eligibility, when PFS is used as a surrogate primary endpoint for OS in randomized clinical trials of first-line treatment for patients with advanced NSCLC.
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spelling doaj-art-435ce5ac8bb84d81a19a8596caca63ba2025-08-20T02:05:45ZengSpringerJournal of Cancer Research and Clinical Oncology0171-52161432-13352014-02-01140583984810.1007/s00432-014-1617-3Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancerMasayuki Aboshi0Masayuki Kaneko1Mamoru Narukawa2Department of Clinical Medicine (Pharmaceutical Medicine), Kitasato University Graduate School of Pharmaceutical SciencesDepartment of Clinical Medicine (Pharmaceutical Medicine), Kitasato University Graduate School of Pharmaceutical SciencesDepartment of Clinical Medicine (Pharmaceutical Medicine), Kitasato University Graduate School of Pharmaceutical SciencesAbstract Purpose New treatment strategies, particularly the introduction of molecular-targeted agents and appropriate patient selection based on histology and/or genotyping, have progressed markedly in recent years, and the overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients has improved. The aim of the study was to identify factors affecting longer OS than that estimated from progression-free survival (PFS) in first-line treatment for advanced NSCLC. Methods Sixty-five controlled trials for first-line treatment of advanced NSCLC were extracted for the study. Factors influencing higher than predicted OS were examined by logistic regression analysis between the OS-extended group and the OS-association group. Results PFS was moderately associated with OS. Twenty arms of 14 trials were categorized as an OS-extended group, in which the ratio of observed OS to estimated OS was found to be over 1.2. On multivariate logistic regression analysis, number of patients lower than 150, average age younger than 63 years, and percentage of squamous carcinoma <30 % were found to significantly affect this relationship. Conclusion We identified number of patients and well-known prognostic factors including age and histological cancer type as factors influencing longer OS. These factors should be considered for patient eligibility, when PFS is used as a surrogate primary endpoint for OS in randomized clinical trials of first-line treatment for patients with advanced NSCLC.https://doi.org/10.1007/s00432-014-1617-3Meta-analysisOverall survivalProgression-free survivalPost-progression survivalNon-small cell lung cancer
spellingShingle Masayuki Aboshi
Masayuki Kaneko
Mamoru Narukawa
Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer
Journal of Cancer Research and Clinical Oncology
Meta-analysis
Overall survival
Progression-free survival
Post-progression survival
Non-small cell lung cancer
title Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer
title_full Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer
title_fullStr Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer
title_full_unstemmed Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer
title_short Factors affecting the association between overall survival and progression-free survival in clinical trials of first-line treatment for patients with advanced non-small cell lung cancer
title_sort factors affecting the association between overall survival and progression free survival in clinical trials of first line treatment for patients with advanced non small cell lung cancer
topic Meta-analysis
Overall survival
Progression-free survival
Post-progression survival
Non-small cell lung cancer
url https://doi.org/10.1007/s00432-014-1617-3
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