Publication
Title
Surrogate endpoints for overall survival in locally advanced head and neck cancer: meta-analyses of individual patient data
Author
Institution/Organisation
MARCH Collaborative Group
MACH-NC Collaborative Group
Abstract
Background The gold standard endpoint in randomised trials of locally advanced head and neck squamous-cell carcinoma (HNSCC) is overall survival. Our objective was to study whether duration of locoregional control or event-free survival (EFS) could be considered as surrogate endpoints to estimate the effect of radiotherapy and chemotherapy on overall survival. This would allow a reduction in the duration and cost of the development of new treatments. Methods Individual patient data from 104 trials (22 744 patients), with 116 treatmentcontrol comparisons, from four meta-analyses on hyperfractionated or accelerated radiotherapy and concomitant, induction, or adjuvant chemotherapy were analysed. Duration of locoregional control was defined as the time from randomisation to the first locoregional event and EFS as the time to any first event (ie, locoregional relapse, distant recurrence, or death). At the individual level, a rank correlation coefficient between the surrogate endpoint and overall survival was used to assess surrogacy; at the trial level, a correlation coefficient R between treatment effects was used. Findings At the individual level, overall survival was more strongly correlated with EFS (range of correlations 0·820·90) than with locoregional control (0·650·76). For radiotherapy, treatment effects on both locoregional control and EFS were strongly correlated with those on overall survival (R=0·94 and 0·98, respectively). For chemotherapy, the correlations between treatment effects on EFS and overall survival were stronger than those between locoregional control and overall survival (range of R 0·790·93 vs 0·530·84, respectively). Interpretation EFS is a better correlate with overall survival than locoregional control and could be used as a surrogate for overall survival to assess the treatment effect of radiotherapy and chemotherapy in randomised trials of locally advanced HNSCC.
Language
English
Source (journal)
The lancet oncology. - London
Publication
London : 2009
ISSN
1470-2045
Volume/pages
10:4(2009), p. 341-350
ISI
000264812300019
Full text (Publishers DOI)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
External links
Web of Science
Record
Identification
Creation 05.05.2009
Last edited 19.04.2017