Meta-Analysis of Recurrence-Free Survival or Disease-Free Survival as a Potential Surrogate Endpoint for Overall Survival in Esophageal Cancer Trials

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-05-19 DOI:10.1002/cnr2.70195

Uchechukwu Love Anyaduba, Oluwatosin Qawiyy Orababa, Zion Faye, Nazia Rashid, Jason Shafrin, Gregory Reardon

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Abstract

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.

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食管癌试验中无复发生存期或无疾病生存期作为总生存期潜在替代终点的meta分析

癌症试验越来越多地使用替代终点，但目前尚不清楚无复发生存期（RFS）或无病生存期（DFS）对可切除食管癌（EC）总生存期（OS）的特异性预测效果。方法通过系统的文献综述，确定具有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hr中估计了合并风险比（hr）。森林样地和异质性检验显示了效应大小和汇总估计。非加权线性回归和加权敏感性分析估计OS与RFS/DFS之间的相关性，生成回归图。结果975篇文献中，11篇符合标准。OS和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Pearson相关性（ρ = 0.89, p < 0.001）。结论：在已知的方法学限制下，RFS/DFS被证明是可切除EC中OS的潜在合适替代终点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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