SynthesisBMC cancer2020
Disease-free survival as a surrogate endpoint for overall survival in adjuvant trials of pancreatic cancer: a meta-analysis of 20 randomized controlled trials.
Synthesis in BMC cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Evaluating relapse-free survival as an endpoint for overall survival in adjuvant immunotherapy trials.Journal of the National Cancer Institute · 2023Pooled it
- Correlation between pathologic complete response, event-free survival/disease-free survival and overall survival in neoadjuvant and/or adjuvant HR+/HER2-breast cancer.Frontiers in oncology · 2023Pooled it
- Phase II Trial of Postoperative Adjuvant Gemcitabine and Cisplatin Chemotherapy Followed by Chemoradiotherapy with Gemcitabine in Patients with Resected Pancreatic Cancer.Cancer research and treatment · 2021Trial
- Evaluation of Progression-Free Survival as a Surrogate Endpoint for Overall Survival in Localized Pancreatic Cancer: Trans-Atlantic Pancreatic Surgery Consortium Study.Annals of surgical oncology · 2026Article
- The surrogacy of disease-free survival for overall survival in locally advanced esophageal squamous cell carcinoma after neoadjuvant therapy.International journal of clinical oncology · 2026Article
- Does Treatment of Jaundice Matter before Pancreaticoduodenectomy? Results from an International Multicentre Recurrence after Whipple (RAW) Study.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026Observational
- High FGFR4 protein expression, but not FGFR1 or FGFR2, predicts poor prognosis in pancreatic ductal adenocarcinoma.BMC cancer · 2025Article
- Disease-free survival as a surrogate for overall survival in early-stage pancreatic cancer trials: a correlation meta-analysis.BMJ oncology · 2025Article
- Surrogate endpoints in clinical trials: when is good...good enough?Hepatobiliary surgery and nutrition · 2024Article
- Frequently asked questions on surrogate endpoints in oncology-opportunities, pitfalls, and the way forward.EClinicalMedicine · 2024Review
- Growth Hormone Receptor Antagonist Markedly Improves Gemcitabine Response in a Mouse Xenograft Model of Human Pancreatic Cancer.International journal of molecular sciences · 2024Article
- Post-operative mortality and recurrence patterns in pancreatic cancer according to KRAS mutation and CDKN2A, p53, and SMAD4 expression.The journal of pathology. Clinical research · 2023Article
- Article
- Assessment of the clinical and cost-effectiveness evidence in the reimbursement decisions of new cancer drugs.ESMO open · 2022Article
- Review
- Pembrolizumab in the adjuvant treatment of melanoma: efficacy and safety.Expert review of anticancer therapy · 2021Article
- Prediction of cancer-specific survival and overall survival in middle-aged and older patients with rectal adenocarcinoma using a nomogram model.Translational oncology · 2021Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed to assess whether disease-free survival (DFS) could serve as a reliable surrogate endpoint for overall survival (OS) in adjuvant trials of pancreatic cancer.
methodsWe systematically reviewed adjuvant randomized trials for non-metastatic pancreatic cancer after curative resection that reported a hazard ratio (HR) for DFS and OS. We assessed the correlation between treatment effect (HR) on DFS and OS, weighted by sample size or precision of hazard ratio estimate, assuming fixed and random effects, and calculated the surrogate threshold effect (STE). We also performed sensitivity analyses and a leave-one-out cross validation approach to evaluate the robustness of our findings.
resultsAfter screening 450 relevant articles, we identified a total of 20 qualifying trails comprising 5170 patients for quantitative analysis. We noted a strong correlation between the treatment effects for DFS and OS, with coefficient of determination of 0.82 in the random effect model, 0.82 in the fixed effect model, and 0.80 in the sample size weighting; the robustness of this finding was further verified by the leave-one-out cross-validation approach. Sensitivity analyses with restriction to phase 3 trials, large trials, trials with mature follow-up periods, and trials with adjuvant therapy versus adjuvant therapy strengthened the correlation (0.75 to 0.88) between DFS and OS. The STE was 0.96 for DFS.
conclusionsTherefore, DFS could be regarded as a surrogate endpoint for OS in adjuvant trials of pancreatic cancer. In future similar adjuvant trials, a hazard ratio for DFS of 0.96 or less would predict a treatment impact on OS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.