Development-free survival (PFS) is a surrogate endpoint is outlined as follows (by ChatGPT):
In essence, PFS refers back to the size of time throughout a medical research or remedy routine the place a affected person’s illness doesn’t worsen or progress. As an illustration, in most cancers analysis, it measures the time from the beginning of remedy till the most cancers exhibits indicators of progress, unfold, or relapse.
Understanding PFS is significant as a result of it helps clinicians and researchers assess the effectiveness of a remedy in controlling the illness. An extended PFS means that the remedy is efficiently slowing down the development of the sickness. This metric is especially vital in medical trials when evaluating completely different remedy approaches or medicine.
A key query is, do sufferers care about PFS? The reply could also be sure, as a result of higher PFS is most frequently (however not all the time) correlated with longer survival. Nonetheless, do sufferers worth PFS unbiased of OS? Maybe so if their high quality of life is best (i.e., they’ve fewer signs) throughout the pre-progression part. Or, maybe they’ve decrease anxiousness in the event that they know their most cancers has not progressed.
What does the literature say?
A paper by Raphael et al. (2019) performed a scientific literature overview of research that consider whether or not sufferers with superior most cancers perceive and worth PFS. General, 17 research met their inclusion standards. Of those:
Ten research particularly offered sufferers with the time period progression-free survival as an attribute selection. Within the phrases used to outline the attribute of PFS, 6 research used the time period survival. 5 research clarified that PFS could not translate into higher general survival, and 5 research defined that enhancements in PFS could not replicate how properly the affected person could really feel. No research clarified {that a} PFS occasion may characterize both development or demise, and no research outlined for the affected person what constituted development. The research assessed herein underrepresented ethnic and racial minorities (imply proportion of white sufferers, 88%; vary, 77%-96%). Values and preferences could range throughout cultural backgrounds on condition that completely different relative preferences had been assigned to value and efficacy outcomes in North American vs Asian research, though only some research had been evaluated.
As you’ll be able to see from the desk beneath, there may be important heterogeneity by way of how PFS was offered to the most cancers affected person respondents.
In a few of the research, PFS was crucial attribute. In others, high quality of life components had been extra vital. General, nonetheless, it’s clear that extra analysis is required to completely perceive how sufferers understand the worth of PFS.
