PAI (Policy Analysis Inc.), 4 Davis Court, Brookline, MA 02445, USA.
Br J Cancer. 2012 Sep 25;107(7):1059-68. doi: 10.1038/bjc.2012.367. Epub 2012 Aug 30.
The relationship between progression-free survival and time to progression (PFS/TTP) and overall survival (OS) has been demonstrated in a variety of solid tumours but not in metastatic renal cell carcinoma (mRCC).
A systematic literature search was conducted to identify controlled trials of cytokine or targeted therapies for mRCC reporting information on treatment effects on PFS/TTP and OS for one or more comparison. The associations between treatment effects on PFS/TTP and OS were analysed using linear regression.
Thirty-one studies representing 10943 patients, 75 treatment groups, and 41 comparisons were identified. The correlation coefficient between the negative log of the hazard ratio (HR) for PFS/TTP (-ln HR(PFS/TTP)) vs the negative log of the HR for OS (-ln HR(OS)) was 0.80 (P<0.0001). In linear regression, the coefficient on -ln HR(PFS/TTP) vs -ln HR(OS) was 0.64 (95% confidence interval (CI): 0.470.81; R(2)=0.63), suggesting each 10% relative risk reduction (RRR) for PFS/TTP was associated with a 6% RRR for OS. A 1-month gain in median PFS/TTP was associated with a 1.17-month gain in median OS (95% CI: 0.59,1.76; R(2)=0.28).
In trials of treatments for mRCC, treatment effects on PFS/TTP are strongly associated with treatment effects on OS.
无进展生存期（progression-free survival，PFS）与进展时间（time to progression，TTP）和总生存期（overall survival，OS）之间的关系已在多种实体瘤中得到证实，但在转移性肾细胞癌（metastatic renal cell carcinoma，mRCC）中尚未得到证实。
系统检索了评估细胞因子或靶向治疗 mRCC 的临床试验，以确定报告了一种或多种比较的治疗效果对 PFS/TTP 和 OS 影响的文献。使用线性回归分析 PFS/TTP 和 OS 治疗效果之间的相关性。
确定了 31 项研究，涉及 10943 例患者、75 个治疗组和 41 个比较。PFS/TTP 的风险比（hazard ratio，HR）的负对数（-ln HR(PFS/TTP))与 OS 的 HR 的负对数（-ln HR(OS))之间的相关系数为 0.80（P<0.0001）。在线性回归中，-ln HR(PFS/TTP)与 -ln HR(OS)的系数为 0.64（95%置信区间（confidence interval，CI）：0.47~0.81；R(2)=0.63），提示 PFS/TTP 的每 10%相对风险降低（relative risk reduction，RRR）与 OS 的 6% RRR 相关。PFS/TTP 中位数增加 1 个月与 OS 中位数增加 1.17 个月相关（95% CI：0.59，1.76；R(2)=0.28）。
在 mRCC 的治疗试验中，PFS/TTP 的治疗效果与 OS 的治疗效果密切相关。
