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Why post‐progression survival and post‐relapse survival are not appropriate measures of efficacy in cancer randomized clinical trials
Author(s) -
GarcíaAlbéniz Xabier,
Maurel Joan,
Hernán Miguel A.
Publication year - 2014
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.29278
Subject(s) - randomized controlled trial , medicine , clinical trial , oncology , cancer , overall survival , selection (genetic algorithm) , survival analysis , cancer survival , artificial intelligence , computer science
Comparisons of post‐relapse survival (PRS) and post‐progression survival have been used to measure efficacy in some cancer clinical trials. These comparisons are an attempt to account for second‐line therapies and to identify benefits that do not translate in longer overall survival. However, the use of PRS comparisons can be misleading (either a longer or shorter PRS may indicate a benefit, depending on the circumstances) and can result in biased estimates (because of selection). Here, we describe the problems surrounding PRS comparisons and propose alternative approaches to deal with non‐randomized therapies administered after progression to the experimental treatment.