Progression Free Survival

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Progression-free survival ( Engl. Progression-free survival , PFS) is a term used in oncology . It is usually defined as the time between the start of a clinical trial and the onset of disease progression or the patient's date of death , whichever comes first. The cause of death does not matter. The unit of time is usually month or year .

Progression-free survival is used as the primary or secondary endpoint in many oncology clinical trials . The value of progression-free survival for the patient as opposed to overall survival or other quality of life-adjusted measures is questioned.

The time intervals for progression-free survival are generally shorter than those for overall survival, since in the latter case the period between the progression of the disease and death is added to the calculation. Overall survival is defined as the time between the start of the study and the death of the patient, regardless of the cause of death. If contact with the patient breaks off - for whatever reason - the last contact with the patient is often set as the end point of the time span in studies.

Special aspects

Correct interpretation of survival data from clinical cancer studies can be difficult, and pitfalls related to the nature of Kaplan-Meier analyzes can lead to incorrect conclusions. In evaluating a randomized controlled trial, the authors of a methodological study encountered some statistical problems that were obviously difficult to identify and possibly associated with a misinterpretation of survival functions. These topics included the assumed crossing of survival curves, the change in the statistical approach in the follow-up examination, the different pretreatment between the groups and event-free survival as the primary outcome.

literature

  • S. Green et al .: Clinical trials in oncology. Chapman & Hall Verlag, 2nd edition, 2002, ISBN 1-584-88302-2 , p. 45.
  • TW Shields et al: General thoracic surgery. Lippincott Williams & Wilkins Verlag, 6th edition, 2004, ISBN 0-781-73889-X , p. 1416.
  • Effects of cancer drugs on survival: often poorly evaluated. Prescrire International, Aug 2009, 18 (102): 180-3

Individual evidence

  1. ^ Ozols RF: Maintenance therapy in advanced ovarian cancer: progression-free survival and clinical benefit . In: J. Clin. Oncol. . 21, No. 13, July 2003, pp. 2451-3. doi : 10.1200 / JCO.2003.03.039 . PMID 12829660 .
  2. ↑ Knox JJ: Progression-free survival as endpoint in metastatic RCC? . In: The Lancet . 372, No. 9637, August 2008, pp. 427-9. doi : 10.1016 / S0140-6736 (08) 61040-5 . PMID 18653227 .
  3. ↑ Peinemann F: Issues possibly associated with misinterpreting survival data: a method study . In: Journal of Evidence-Based Medicine . 11, No. 3, June 2018, pp. 208–215. doi : 10.1111 / jebm.12301 . PMID 29877035 .