SynthesisJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020
Event-Free Survival, a Prostate-Specific Antigen-Based Composite End Point, Is Not a Surrogate for Overall Survival in Men With Localized Prostate Cancer Treated With Radiation.
Synthesis in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Intermediate clinical endpoints for surrogacy in localised prostate cancer: an aggregate meta-analysis.The Lancet. Oncology · 2021Pooled it
- Association of PSA kinetics after testosterone recovery with subsequent recurrence: secondary analysis of a phase III randomized controlled trial.World journal of urology · 2023Trial
- Adding Short-Term Androgen Deprivation Therapy to Radiation Therapy in Men With Localized Prostate Cancer: Long-Term Update of the NRG/RTOG 9408 Randomized Clinical Trial.International journal of radiation oncology, biology, physics · 2022Trial
- How positive was PROTEUS? Reconsidering success when most patients never reach no evidence of disease.Nature reviews. Clinical oncology · 2026Article
- Salvage Radiotherapy Confers an Overall Survival Advantage in Biochemical Recurrence of Prostate Cancer: Evidence from the International PROMISE Registry.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026Observational
- Association of Preoperative Pan-Immune-Inflammation Value with Adverse Pathology and Oncological Outcomes Following Radical Prostatectomy: A Single-Center Retrospective Study.International journal of medical sciences · 2026Article
- Statistical approaches for component-wise censored composite endpoints.Clinical trials (London, England) · 2024Article
- Moderately hypofractionated prostate-only versus whole-pelvis radiotherapy for high-risk prostate cancer: A retrospective real-world single-center cohort study.Clinical and translational radiation oncology · 2024Article
- Validation of metastasis-free survival as a surrogate endpoint for overall survival in localized prostate cancer in the era of docetaxel for castration-resistant prostate cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2024Article
- Salvage Radiotherapy for Relapsed Prostate Cancer after Radical Prostatectomy Is Associated with Normal Life Expectancy.Cancers · 2024Article
- Long-term outcomes of LDR-brachytherapy for localized prostate cancer.Frontiers in oncology · 2024Article
- A US real-world study of treatment patterns and outcomes in localized or locally advanced prostate cancer patients.World journal of urology · 2023Article
- Biochemical Recurrence Surrogacy for Clinical Outcomes After Radiotherapy for Adenocarcinoma of the Prostate.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Early Endpoints in High-risk Localized Prostate Cancer: Exploratory Analysis of Three Radiation Therapy Oncology Group Phase 3 Studies.European urology · 2023Article
- A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial.European urology open science · 2023Article
- Biochemical Failure Is Not a Surrogate End Point for Overall Survival in Recurrent Prostate Cancer: Analysis of NRG Oncology/RTOG 9601.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Article
- Survival Outcomes in Men with Unfavorable Intermediate-Risk and High-Risk Prostate Cancer Treated with Prostate-Only versus Whole Pelvic Radiation Therapy.The Journal of urology · 2022Article
- A novel ferroptosis-related gene prognostic index for prognosis and response to immunotherapy in patients with prostate cancer.Frontiers in endocrinology · 2022Article
- The Role of Long Non-Coding RNAs in Epithelial-Mesenchymal Transition-Related Signaling Pathways in Prostate Cancer.Frontiers in molecular biosciences · 2022Review
- Cost-effectiveness analysis of ultra-hypofractionated radiotherapy and conventionally fractionated radiotherapy for intermediate- to high-risk localized prostate cancer.Frontiers in oncology · 2022Article
Corrections and comments
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Authors and funding
27 authors at 20 institutions in 6 countries.
Funding
Abstract
purposeRecently, we have shown that metastasis-free survival is a strong surrogate for overall survival (OS) in men with intermediate- and high-risk localized prostate cancer and can accelerate the evaluation of new (neo)adjuvant therapies. Event-free survival (EFS), an earlier prostate-specific antigen (PSA)-based composite end point, may further expedite trial completion.
methodsEFS was defined as the time from random assignment to the date of first evidence of disease recurrence, including biochemical failure, local or regional recurrence, distant metastasis, or death from any cause, or was censored at the date of last PSA assessment. Individual patient data from trials within the Intermediate Clinical Endpoints in Cancer of the Prostate-ICECaP-database with evaluable PSA and disease follow-up data were analyzed. We evaluated the surrogacy of EFS for OS using a 2-stage meta-analytic validation model by determining the correlation of EFS with OS (patient level) and the correlation of treatment effects (hazard ratios [HRs]) on both EFS and OS (trial level). A clinically relevant surrogacy was defined a priori as an
resultsData for 10,350 patients were analyzed from 15 radiation therapy-based trials enrolled from 1987 to 2011 with a median follow-up of 10 years. At the patient level, the correlation of EFS with OS was 0.43 (95% CI, 0.42 to 0.44) as measured by Kendall's tau from a copula model. At the trial level, the
conclusionEFS is a weak surrogate for OS and is not suitable for use as an intermediate clinical end point to substitute for OS to accelerate phase III (neo)adjuvant trials of prostate cancer therapies for primary radiation therapy-based trials.
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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.