食管癌试验中无复发生存期或无病生存期作为总生存期潜在替代终点的Meta分析。
Meta-Analysis of Recurrence-Free Survival or Disease-Free Survival as a Potential Surrogate Endpoint for Overall Survival in Esophageal Cancer Trials.
作者信息
Anyaduba Uchechukwu Love, Orababa Oluwatosin Qawiyy, Faye Zion, Rashid Nazia, Shafrin Jason, Reardon Gregory
机构信息
Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute, Claremont, California, USA.
School of Life Sciences, Gibbet Hill Campus, University of Warwick, Coventry, UK.
出版信息
Cancer Rep (Hoboken). 2025 May;8(5):e70195. doi: 10.1002/cnr2.70195.
BACKGROUND
Cancer trials increasingly use surrogate endpoints, but it is unclear how well recurrence-free survival (RFS) or disease-free survival (DFS) specifically predict overall survival (OS) in resectable esophageal cancer (EC).
METHODS
A systematic literature review identified trials with RFS/DFS and OS endpoints. A meta-analysis assessed RFS/DFS as surrogates for OS, estimating pooled hazard ratios (HRs) from trial HRs. Forest plots and heterogeneity tests showed effect sizes and pooled estimates. Unweighted linear regression and weighted sensitivity analysis estimated the correlation between OS and RFS/DFS, producing a regression plot.
RESULTS
Of 975 articles identified, 11 met the criteria. The pooled HR for OS and RFS/DFS was 0.90 and 0.87, respectively. The primary analysis showed a strong Pearson correlation between RFS/DFS and OS (ρ = 0.89, p < 0.001).
CONCLUSION
Subject to known methodological limits, RFS/DFS was demonstrated to be a potentially suitable surrogate endpoint for OS in resectable EC.
背景
癌症试验越来越多地使用替代终点，但尚不清楚无复发生存期（RFS）或无病生存期（DFS）在可切除食管癌（EC）中对总生存期（OS）的预测效果究竟如何。
方法
一项系统的文献综述确定了具有RFS/DFS和OS终点的试验。一项荟萃分析评估了RFS/DFS作为OS的替代指标，从试验的风险比（HR）估计合并风险比（HR）。森林图和异质性检验显示了效应大小和合并估计值。非加权线性回归和加权敏感性分析估计了OS与RFS/DFS之间的相关性，生成了回归图。
结果
在识别出的975篇文章中，11篇符合标准。OS与RFS/DFS的合并HR分别为0.90和0.87。初步分析显示RFS/DFS与OS之间存在很强的皮尔逊相关性（ρ = 0.89，p < 0.001）。
结论
在已知方法学局限性的情况下，RFS/DFS被证明是可切除EC中OS的一个潜在合适替代终点。
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