TY - JOUR
T1 - Alternative end points to evaluate a therapeutic strategy in advanced colorectal cancer
T2 - Evaluation of progression-free survival, duration of disease control, and time to failure of strategy - An Aide et Recherche en Canceŕologie Digestive Group study
AU - Chibaudel, Benoist
AU - Bonnetain, Franck
AU - Shi, Qian
AU - Buyse, Marc
AU - Tournigand, Christophe
AU - Sargent, Daniel J.
AU - Allegra, Carmen J.
AU - Goldberg, Richard M.
AU - De Gramont, Aimery
PY - 2011/11/1
Y1 - 2011/11/1
N2 - Purpose: Progression-free survival (PFS) is not an optimal end point to evaluate therapeutic strategies in advanced colorectal cancer (ACRC). Therefore, composite end points have been proposed to evaluate a chemotherapy strategy when sequential treatments are available: duration of disease control (DDC) and time to failure of strategy (TFS). The goal of this study was to evaluate these alternative end points and their potential surrogacy for overall survival (OS). Methods: We pooled individual patient data from three randomized trials evaluating chemotherapy strategy, which accrued 1,042 patients with previously untreated ACRC. In these trials, first-line treatment was either oxaliplatin- or irinotecan-based chemotherapy. Compared with TFS, DDC included neither time interval between progression and next sequence of treatment nor time to progression if the best result of the next sequence of treatment was progression. Results: There was good correlation between DDC and OS (correlation of median: r, 0.62; correlation of hazard ratio [HR]: adjusted copula R 2, 0.72) and between TFS and OS (correlation of median: r, 0.59; correlation of HR: adjusted copula R 2, 0.67). There was no correlation between PFS and OS (correlation of median: r, 0.45; correlation of HR: adjusted copula R 2, 0.47). Conclusion: DDC and TFS roughly achieved the same results. Both are acceptable new end points to evaluate a therapeutic strategy in ACRC. Although TFS achieved a pragmatic evaluation of a multiline strategy, DDC captured the effect of a specific sequence in a therapeutic strategy.
AB - Purpose: Progression-free survival (PFS) is not an optimal end point to evaluate therapeutic strategies in advanced colorectal cancer (ACRC). Therefore, composite end points have been proposed to evaluate a chemotherapy strategy when sequential treatments are available: duration of disease control (DDC) and time to failure of strategy (TFS). The goal of this study was to evaluate these alternative end points and their potential surrogacy for overall survival (OS). Methods: We pooled individual patient data from three randomized trials evaluating chemotherapy strategy, which accrued 1,042 patients with previously untreated ACRC. In these trials, first-line treatment was either oxaliplatin- or irinotecan-based chemotherapy. Compared with TFS, DDC included neither time interval between progression and next sequence of treatment nor time to progression if the best result of the next sequence of treatment was progression. Results: There was good correlation between DDC and OS (correlation of median: r, 0.62; correlation of hazard ratio [HR]: adjusted copula R 2, 0.72) and between TFS and OS (correlation of median: r, 0.59; correlation of HR: adjusted copula R 2, 0.67). There was no correlation between PFS and OS (correlation of median: r, 0.45; correlation of HR: adjusted copula R 2, 0.47). Conclusion: DDC and TFS roughly achieved the same results. Both are acceptable new end points to evaluate a therapeutic strategy in ACRC. Although TFS achieved a pragmatic evaluation of a multiline strategy, DDC captured the effect of a specific sequence in a therapeutic strategy.
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U2 - 10.1200/JCO.2011.35.5867
DO - 10.1200/JCO.2011.35.5867
M3 - Article
C2 - 21969501
AN - SCOPUS:80755155711
SN - 0732-183X
VL - 29
SP - 4199
EP - 4204
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 31
ER -