ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2022
Biochemical Failure Is Not a Surrogate End Point for Overall Survival in Recurrent Prostate Cancer: Analysis of NRG Oncology/RTOG 9601.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- PSMA PET-guided intensification of postprostatectomy salvage radiotherapy for prostate cancer: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Salvage therapies for biochemical recurrence after definitive local treatment: a systematic review, meta-analysis, and network meta-analysis.Prostate cancer and prostatic diseases · 2025Pooled it
- Genomic classifiers and prognosis of localized prostate cancer: a systematic review.Prostate cancer and prostatic diseases · 2025Pooled it
- Efficacy and safety of salvage radiotherapy combined with endocrine therapy in patients with biochemical recurrence after radical prostatectomy: A systematic review and meta-analysis of randomized controlled trials.Frontiers in oncology · 2022Pooled it
- Phase II Randomized Study of Salvage Radiation Therapy Plus Enzalutamide or Placebo for High-Risk Prostate-Specific Antigen Recurrent Prostate Cancer After Radical Prostatectomy: The SALV-ENZA Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Evaluating Risk Factors Associating With Late Recurrence After Low-Dose-Rate Brachytherapy for Prostate Cancer Using Machine Learning.The Prostate · 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
- Towards implementation of precision medicine biomarkers in early detection and prognostication of prostate cancer.Cancer metastasis reviews · 2026Review
- Salvage radiotherapy with or without hormonal therapy for biochemical recurrence after radical prostatectomy: A systematic review and meta-analysis.Prostate cancer and prostatic diseases · 2026Review
- Development of a novel risk model to predict CRPC progression following IMRT: Implications for tailoring treatment intensity.BJUI compass · 2025Article
- Impact of Cribriform Pattern on Progression-Free Survival After Radical Prostatectomy in Gleason Score 8-10 Prostate Cancer.The Eurasian journal of medicine · 2025Article
- High-risk biochemical recurrence of locally treated prostate cancer after EMBARK. An end to decades of conventional wisdom?Prostate cancer and prostatic diseases · 2024Review
- Surrogacy validation for time-to-event outcomes with illness-death frailty models.Biometrical journal. Biometrische Zeitschrift · 2024Article
- Outcomes after definitive radiation therapy for localized prostate cancer in a national health care delivery system.Cancer · 2023Article
- PSMA-PET/CT-guided salvage radiotherapy in recurrent or persistent prostate cancer and PSA < 0.2 ng/ml.European journal of nuclear medicine and molecular imaging · 2023Article
- Development and Validation of a Multi-institutional Nomogram of Outcomes for PSMA-PET-Based Salvage Radiotherapy for Recurrent Prostate Cancer.JAMA network open · 2023Article
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Authors and funding
19 authors at 12 institutions in 2 countries.
Funding
Abstract
purposeMetastasis-free survival (MFS), but not event-free survival, is a validated surrogate end point for overall survival (OS) in men treated for localized prostate cancer. It remains unknown if this holds true in biochemically recurrent disease after radical prostatectomy. Leveraging NRG/RTOG 9601, we aimed to determine the performance of intermediate clinical end points (ICEs) as surrogate end points for OS in recurrent prostate cancer. MATERIALS AND
methodsNRG/RTOG 9601 randomly assigned 760 men with recurrence after prostatectomy to salvage radiation therapy with 2 years of placebo versus bicalutamide 150 mg daily. ICEs assessed were biochemical failure (BF) per NRG/RTOG 9601 (prostate-specific antigen nadir + 0.3-0.5 ng/mL or initiation of salvage hormone therapy; [BF1]) and NRG/RTOG 0534 (prostate-specific antigen nadir+2 ng/mL; [BF2]), distant metastasis (DM), and MFS (DM or death). Surrogacy was assessed by the Prentice criteria and a two-stage meta-analytic approach (condition one assessed at the patient level with Kendall's τ and condition two assessed by randomly dividing the entire trial cohort into 10 pseudo trial centers and calculating the average
resultsBF1, BF2, DM, and MFS satisfied the four Prentice criteria. However, with the two-condition meta-analytic approach, there was strong correlation between MFS and OS (τ = 0.86), moderate correlation between DM and OS (τ = 0.66), and weaker correlation between BF1 (τ = 0.25) or BF2 (τ = 0.40) and OS. Similarly, for condition two, the treatment effect of antiandrogen therapy on MFS and OS were correlated (
conclusionMFS is also a strong surrogate for OS in men receiving salvage radiation therapy for recurrence after prostatectomy. Caution should be used when inferring survival benefit from effects on BF in biochemically recurrent prostate cancer. Lack of comorbidity data did not allow us to assess whether BF in men with no/minimal comorbidity could serve as a surrogate for OS.
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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.