Correlation Between Early Endpoints and Overall Survival in Non-Small-Cell Lung Cancer: A Trial-Level Meta-Analysis.

Early endpoints, such as progression-free survival (PFS), are increasingly used as surrogates for overall survival (OS) to accelerate approval of novel oncology agents. Compiling trial-level data from randomized controlled trials (RCTs) could help to develop a predictive framework to ascertain correlation trends between treatment effects for early and late endpoints. Through trial-level correlation and random-effects meta-regression analysis, we assessed the relationship between hazard ratio (HR) OS and (1) HR PFS and (2) odds ratio (OR) PFS at 4 and 6 months, stratified according to the mechanism of action of the investigational product. Using multiple source databases, we compiled a data set including 81 phase II-IV RCTs (35 drugs and 156 observations) of patients with non-small-cell lung cancer. Low-to-moderate correlations were generally observed between treatment effects for early endpoints (based on PFS) and HR OS across trials of agents with different mechanisms of action. Moderate correlations were seen between treatment effects for HR PFS and HR OS across all trials, and in the programmed cell death-1/programmed cell death ligand-1 and epidermal growth factor receptor trial subsets. Although these results constitute an important step, caution is advised, as there are some limitations to our evaluation, and an additional patient-level analysis would be needed to establish true surrogacy.

Informations de copyright

Copyright © 2021 Shameer, Zhang, Jackson, Rhodes, Neelufer, Nampally, Prokop, Hutchison, Ye, Malkov, Liu, Sabin, Weatherall, Duran, Iacona, Khan and Mukhopadhyay.

Déclaration de conflit d'intérêts

KR, EH, FL, AS, JW, RI, and FK are full-time employees of AstraZeneca and own AstraZeneca stock. SK, YZ, DJ, SN, AP, JY, and CD are full-time employees of AstraZeneca. PM was a full-time employee of AstraZeneca at the time that the study was conducted and owns AstraZeneca stock. IK and VM were full-time employees of AstraZeneca at the time that the study was conducted. The authors declare that this study received funding from AstraZeneca. The funder had the following involvement with the study: Study design and concept, collection, analysis and interpretation of the data, review and approval of the final draft and approval to submit for publication.