Evaluation of Progression-Free Survival as a Surrogate End Point in Primary CNS Lymphoma: a Systematic Review and Meta-Analysis

Abstract

Purpose: To evaluate progression-free survival (PFS) as early surrogate endpoints for overall survival (OS) in primary CNS lymphoma (PCNSL). Methods: PubMed, Embase and Cochrane Central Library were searched up to 7 June 2022. Trial-level analyses were performed by weighted linear regression of logarithmic hazard ratios for PFS and OS. Treatment arm-level analyses were performed between PFS rates and 3- or 5-year OS rates. Results: 1471 PCNSL patients in nine randomized control trials were included. PFS was associated with OS (r = 0.750; 95% CI: 0.228–0.937). Strong linear correlations existed between 1-, 2- and 3-year PFS and 3-year OS (r = 0.896–0.928), moderate or weak correlations existed between 3- to 6-month PFS and 3-year OS, 3-month to 5-year PFS and 5-year OS. Conclusion: Short-term PFS can validly substitute for long-term OS in PCNSL.

Keywords::

• overall survival
• primary CNS lymphoma
• prognosis
• progression-free survival
• surrogate end point

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2023-0529

Author contributions

Study design: W Zhang and J Zhan; Data collection: J Zhan and SJ Yang; Literature search: J Zhan and SJ Yang; Study selection: J Zhan; Study draft and revision: J Zhan, SJ Yang, W Zhang, DB Zhou, Y Zhang, W Wang, C Wei, DQ Zhao. All authors read and approved the final manuscript.

Financial disclosure

Funding was provided by the National Natural Science Foundation of China (No. 81970188) and CAMS Innovation Fund for Medical Sciences (2016-12M-1-001). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

Funding was provided by the National Natural Science Foundation of China (No. 81970188) and CAMS Innovation Fund for Medical Sciences (2016-12M-1-001). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.