ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2015
Multitrial Evaluation of Progression-Free Survival as a Surrogate End Point for Overall Survival in First-Line Extensive-Stage Small-Cell Lung Cancer.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The Optimal First-Line Therapy for Extensive-Stage Small-Cell Lung Cancer Based on Liver Metastasis Status: A Network Meta-Analysis and Systematic Review.Cancer medicine · 2024Pooled it
- Progression-Free Survival and Time to Progression as Potential Surrogate Endpoints for Overall Survival in Chemoradiotherapy Trials in Limited-Stage Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2022Pooled it
- Pooled it
- Consideration of Surrogate Endpoints for Overall Survival Associated With First-Line Immunotherapy in Extensive-Stage Small Cell Lung Cancer.Frontiers in oncology · 2021Pooled it
- Optimized Image-Based Surrogate Endpoints in Targeted Therapies for Glioblastoma: A Systematic Review and Meta-Analysis of Phase III Randomized Controlled Trials.Korean journal of radiology · 2020Pooled it
- Updated Overall Survival and PD-L1 Subgroup Analysis of Patients With Extensive-Stage Small-Cell Lung Cancer Treated With Atezolizumab, Carboplatin, and Etoposide (IMpower133).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Trial
- Immunotherapeutic maintenance treatment with toll-like receptor 9 agonist lefitolimod in patients with extensive-stage small-cell lung cancer: results from the exploratory, controlled, randomized, international phase II IMPULSE study.Annals of oncology : official journal of the European Society for Medical Oncology · 2018Trial
- Trial
- Impact of post-resistance molecular retesting strategies on treatment timeliness and clinical outcomes in EGFR-mutant advanced NSCLC: a real-world study.Frontiers in oncology · 2026Article
- Impact of hepatic radiotherapy on survival and safety outcomes in small cell lung cancer patients with liver metastases: a retrospective study.Therapeutic advances in medical oncology · 2026Article
- Pre-screening value of serum albumin and the glucose-lymphocyte ratio as the "transport-activation" effectors of immune checkpoint inhibitors in small cell lung cancer.Translational lung cancer research · 2025Article
- Clinical significance of post‑progression survival after chemoradiotherapy on overall survival in limited‑disease small cell lung cancer.Molecular and clinical oncology · 2025Article
- Advancements in consolidative thoracic radiotherapy following first-line immunotherapy in conjunction with chemotherapy for extensive-stage small cell lung cancer.Frontiers in immunology · 2025Review
- Article
- Radiotherapy for extensive-stage small-cell lung cancer in the immunotherapy era.Frontiers in immunology · 2023Review
- Molecular epidemiology study of programmed death ligand 1 and ligand 2 protein expression assessed by immunohistochemistry in extensive-stage small-cell lung cancer.Frontiers in oncology · 2023Article
- Post-progression survival after atezolizumab plus carboplatin and etoposide as first-line chemotherapy in small cell lung cancer has a significant impact on overall survival.Thoracic cancer · 2022Article
- Article
- Analysis of a Real-World Progression Variable and Related Endpoints for Patients with Five Different Cancer Types.Advances in therapy · 2022Article
- Differences in treatment effect size between progression-free survival and overall survival in anti-PD-1/PD-L1 inhibitors-based trials in advanced NSCLC: a systematic review and meta-analysis.Translational lung cancer research · 2021Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
introductionWe previously reported that progression-free survival (PFS) may be a candidate surrogate end point for overall survival (OS) in first-line extensive-stage small-cell lung cancer (ES-SCLC) using data from three randomized trials (Foster, Cancer 2011). In this validation study (N0424-Alliance), we assessed the patient-level and trial-level surrogacy of PFS using data from seven new first-line phase II/III ES-SCLC trials and across all 10 trials as well (seven new, three previous).
methodsIndividual patient data were utilized across the seven new trials (2259 patients) and all 10 trials (2855 patients). Patient-level surrogacy (Kendall's τ) was assessed using the Clayton copula bivariate survival model. Trial-level surrogacy was assessed through association of the log hazard ratios on OS and PFS across trials, including weighted (by trial size) least squares regression (WLS R²) of Cox model effects and correlation of the copula effects (copula R²). The minimum effect on the surrogate (MES) needed to detect a nonzero treatment effect on OS was also calculated.
resultsThe median OS and PFS across all 10 trials were 9.8 and 5.9 months, respectively. PFS showed strong surrogacy within the 7 new trials (copula R² = 0.90 [standard error = 0.27], WLS R² = 0.83 [95% confidence interval: 0.43, 0.95]; MES = 0.67, and Kendall's τ = 0.58) and across all 10 trials (copula R² = 0.81 [standard errors = 0.25], WLS R² = 0.77 [95% confidence interval: 0.47-0.91], MES = 0.70, and Kendall's τ = 0.57).
conclusionsPFS demonstrated strong surrogacy for OS in first-line ES-SCLC based on this external validation study of individual patient data. PFS is a good alternative end point to OS and should be considered when resource constraints (time or patient) might make it useful or desirable in place of OS. Additional analyses are needed to assess its appropriateness for targeted agents in this disease setting.
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