Individual-level data on the relationships of progression-free survival and post-progression survival with overall survival in patients with advanced non-squamous non-small cell lung cancer patients who received second-line chemotherapy
Individual-level data on the relationships of progression-free survival and post-progression survival with overall survival in patients with advanced non-squamous non-small cell lung cancer patients who received second-line chemotherapy
复制标题
DOI：
10.1007/s12032-014-0088-3
复制
发表时间：
2014-08-01
期刊：
影响因子：
3.4
通讯作者：
Takahashi, Toshiaki
中科院分区：
文献类型：
--
作者：
Imai, Hisao;Mori, Keita;Takahashi, Toshiaki
二线化疗对非小细胞肺癌（NSCLC）患者总生存期（OS）的影响可能会受到后续治疗的混淆。由于缺乏这一领域的研究，我们在此使用个体水平的数据，研究了无进展生存期（PFS）或进展后生存期（PPS）是否可以作为晚期NSCLC二线化疗后OS的有效替代终点。分析了2009年4月至2011年6月期间，39例在顺铂和培美曲塞一线化疗后接受二线化疗的晚期非鳞状NSCLC患者。在个体水平上分析PFS和PPS与OS的关系。斯皮尔曼等级相关分析和线性回归分析显示PPS与OS强相关（r = 0.90，p < 0.05，R-2 = 0.85），而PFS与OS仅中度相关（r = 0.76，p < 0.05，R-2 = 0.50）。三线治疗的最佳缓解和二线化疗后进展后使用的方案数量与PPS显著相关（p < 0.05）。对接受二线化疗患者的个体水平数据进行的分析表明，PPS可用作具有未知致癌驱动突变的晚期非鳞状NSCLC患者的OS替代，因此后续化疗的选择有限。此外，我们的研究结果表明，二线化疗后疾病进展后的后续治疗可能会极大地影响OS。然而，这些结果应在进一步的大规模研究中得到验证。
The effects of second-line chemotherapy on overall survival (OS) might be confounded by subsequent therapies in patients with non-small cell lung cancer (NSCLC). Given the lack of research in this area, we here examined whether progression-free survival (PFS) or post-progression survival (PPS) could serve as valid surrogate endpoints for OS after second-line chemotherapy in advanced NSCLC, using individual-level data. Between April 2009 and June 2011, 39 patients with advanced non-squamous NSCLC who had received second-line chemotherapy following first-line chemotherapy treatment with cisplatin and pemetrexed were analysed. The relationships of PFS and PPS with OS were analysed at the individual level. Spearman rank correlation analyses and linear regression analyses showed that PPS was strongly associated with OS (r = 0.90, p < 0.05, R-2 = 0.85), whereas PFS only moderately correlated with OS (r = 0.76, p < 0.05, R-2 = 0.50). Best response at third-line treatment and number of regimens employed after progression beyond second-line chemotherapy were significantly associated with PPS (p < 0.05). Analysis of individual-level data of patients treated with second-line chemotherapy suggested that PPS may be used as a surrogate for OS in patients with advanced non-squamous NSCLC with unknown oncogenic driver mutations and therefore limited options for subsequent chemotherapy. Moreover, our findings suggest that subsequent treatment after disease progression following second-line chemotherapy may greatly influence OS. However, these results should be validated in further large-scale studies.