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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

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Abstract

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.

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Acknowledgments

We wish to thank Ms. Mutsumi Yamazaki, Mr. Taiki Miyauchi, Drs. Kazushige Wakuda, Takuya Oyakawa, Yasushi Hisamatsu, Ryo Koh, Shota Ohmori, and Kazuhisa Nakashima for their assistance in preparing this manuscript.

Conflict of interest

None of the authors declare any financial or personal relationships with other people or organizations that could inappropriately influence this work.

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Authors and Affiliations

  1. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-chou, Suntou-gun, Shizuoka, 411-8777, Japan

    Hisao Imai, Akira Ono, Hiroaki Akamatsu, Tetsuhiko Taira, Hirotsugu Kenmotsu, Tateaki Naito, Kyoichi Kaira, Haruyasu Murakami & Toshiaki Takahashi

  2. Clinical Trial Coordination Office, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-chou, Suntou-gun, Shizuoka, 411-8777, Japan

    Keita Mori

  3. Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-chou, Suntou-gun, Shizuoka, 411-8777, Japan

    Masahiro Endo

  4. Division of Diagnostic Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-chou, Suntou-gun, Shizuoka, 411-8777, Japan

    Takashi Nakajima

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  1. Hisao Imai
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  2. Keita Mori
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  3. Akira Ono
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  11. Takashi Nakajima
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  12. Toshiaki Takahashi
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Correspondence to Hisao Imai.

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Imai, H., Mori, K., Ono, A. et al. 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. Med Oncol 31, 88 (2014). https://doi.org/10.1007/s12032-014-0088-3

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  • DOI: https://doi.org/10.1007/s12032-014-0088-3

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