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Late divergence of survival curves in cancer immunotherapy trials: interpretation and implications

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Abstract

Late divergence of survival curves of treated patients and controls is commonly seen in successful cancer immunotherapy trials. Although late survival curve divergence may be caused by a delayed action of therapy, it may also be related to early effects of the treatment. We suggest that late survival divergence most often reflects a specific benefit of therapy for patients who suffer from a comparatively slow progression of disease. The occurrence of delayed survival curve divergence has important implications for the statistical analysis of immunotherapy trials. Thus, it leads to non-proportional hazard ratios that make commonly used statistical tests, e.g., the logrank test, suboptimal. It is therefore suggested that the statistical analysis of immunotherapy trials primarily should be based on a test that compares the survival curves at or after a prespecified, fixed, late time point.

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The authors declare no conflict of interest.

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Authors and Affiliations

  1. Sahlgrenska Cancer Center, University of Gothenburg, Box 425, 405 30, Göteborg, Sweden

    Fredrik B. Thorén

  2. Department of Infectious Diseases, University of Gothenburg, Göteborg, Sweden

    Fredrik B. Thorén & Örjan Strannegård

  3. Department of Cancer Epidemiology, University of Lund, Lund, Sweden

    Harald Anderson

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  1. Fredrik B. Thorén
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  2. Harald Anderson
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Correspondence to Fredrik B. Thorén.

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Thorén, F.B., Anderson, H. & Strannegård, Ö. Late divergence of survival curves in cancer immunotherapy trials: interpretation and implications. Cancer Immunol Immunother 62, 1547–1551 (2013). https://doi.org/10.1007/s00262-013-1458-y

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  • DOI: https://doi.org/10.1007/s00262-013-1458-y

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