Correlation of progression-free survival at 6 months (PFS6) with overall survival at 12 months (OS12) in an analysis of 10 trials of second-line therapy for advanced urothelial carcinoma (UC).
Bibliographic record
Abstract
4525 Background: Second-line therapy of advanced UC is a significant unmet need. While phase II trials have relied on response rate (RR) as a primary endpoint, response may not be suitable for assessing cytostatic agents and does not capture duration of benefit. We hypothesized that PFS6 correlates with OS12 and may be a robust intermediate endpoint for phase II trials. Methods: Ten trials with individual patient progression and survival data (n=646) evaluating chemotherapy and/or biologics following chemotherapy were combined. Progression was defined as tumor progression (RECIST 1.0 in 9 trials, WHO in 1 trial), or death from any cause. Unadjusted and adjusted binomial confidence intervals for PFS6, OS12 and response were reported, with adjustment for variability between trials using random effects models. The relationship between PFS6 and OS12 was assessed at the trial level using Pearson correlation and weighted linear regression with larger studies having more influence. The relationship between PFS6 and OS12 at the individual level was assessed using Pearson chi-square test with Yates continuity correction. Statistical analyses employed “R” statistical computing software, version 2.8.0. Results: 59% had visceral metastasis and performance status was 0, 1 and 2 in 50, 39 and 8%, respectively. Median age was 65 years (31-88) and 77% were male. PFS6 was 22% (95% CI: 17-24%), and adjusted PFS6 was 23% (95% CI: 15-34%). The OS12 was 20% (95% CI: 17-24%), and adjusted OS12 was 21% (95% CI: 15-29%). The Pearson correlation between trial level PFS6 and OS12 was 0.66 (p = 0.037). The individual level agreement between PFS6 and OS12 was seen in 82% of patients (kappa = 0.45). Among 560 patients evaluable for response and OS, the RR was 22% (95% CI: 18-25%) and adjusted RR was 21% (95% CI: 13-32%). Trial level Pearson correlation between response and OS12 was 0.37 (p = 0.30), and individual level agreement was seen in 78% (kappa=0.36). Conclusions: PFS6 is associated with OS12 at the trial and individual levels in patients receiving second-line therapy for advanced UC. The association of response with OS was suboptimal. Validation of PFS6 is warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.006 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".