Correlation between imaging-based intermediate endpoints and overall survival in men with metastatic castration-resistant prostate cancer: Analysis of 28 randomized trials using the Prostate Cancer Clinical Trials Working Group (PCWG2) criteria in 16,511 patients Journal Article


Authors: Woo, S.; Suh, C. H.; Wibmer, A. G.; Becker, A. S.; Teo, M. Y.; Gönen, M.; Hricak, H.; Scher, H. I.; Morris, M. J.; Vargas, H. A.
Article Title: Correlation between imaging-based intermediate endpoints and overall survival in men with metastatic castration-resistant prostate cancer: Analysis of 28 randomized trials using the Prostate Cancer Clinical Trials Working Group (PCWG2) criteria in 16,511 patients
Abstract: Introduction/Background: Radiographic progression-free survival (rPFS) based on Prostate Cancer Working Group 2 (PCWG2) has been increasingly used as a meaningful imaging-based intermediate endpoint (IBIE) for overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC). In randomized phase III trials, rPFS showed good correlation with OS at the individual trial level. We aimed to assess the correlation between the hazard ratios (HR) of IBIE and OS among PCWG2-based randomized trials. Materials and Methods: PubMed and EMBASE databases were systematically searched for randomized trials evaluating systemic treatments on mCRPC using PCWG2 up to April 15, 2020. Hazard ratios for OS and IBIEs were extracted and their correlation was assessed using weighted linear regression. Subgroup analyses were performed according to various clinical settings: prior chemotherapy, drug category, type of IBIE (rPFS vs. composite IBIE, latter defined as progression by imaging and one or a combination of PSA, pain, skeletal-related events, and performance status), and publication year. Results: Twenty-eight phase II-III randomized trials (16,511 patients) were included. Correlation between OS and IBIE was good (R2 = 0.57, 95% confidence interval [CI], 0.35-0.78). Trials using rPFS showed substantially higher correlation than those using a composite IBIE (R2 = 0.58, 95% CI, 0.32-0.82 vs. 0.00, 95% CI, −0.01 to 0.01). Correlations between OS and IBIE in other subgroups were at least moderate in nearly all subgroups (R2 = 0.32-0.91). Conclusion: IBIEs in the era of PCWG2 correlate well with OS in randomized trials for systemic drugs in patients with mCRPC. PCWG2-based rPFS should be used instead of a composite IBIE that includes PSA and other clinical variables. © 2021
Keywords: overall survival; castration-resistant prostate cancer; radiographic progression-free survival; imaging-based intermediate endpoint; prostate cancer working group 2
Journal Title: Clinical Genitourinary Cancer
Volume: 20
Issue: 1
ISSN: 1558-7673
Publisher: Elsevier Inc.  
Date Published: 2022-02-01
Start Page: 69
End Page: 79
Language: English
DOI: 10.1016/j.clgc.2021.11.007
PUBMED: 34903480
PROVIDER: scopus
PMCID: PMC8816823
DOI/URL:
Notes: Article -- Export Date: 1 March 2022 -- Source: Scopus
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MSK Authors
  1. Michael Morris
    577 Morris
  2. Mithat Gonen
    1028 Gonen
  3. Hedvig Hricak
    419 Hricak
  4. Howard Scher
    1130 Scher
  5. Andreas Georg Wibmer
    53 Wibmer
  6. Min Yuen   Teo
    104 Teo
  7. Sungmin Woo
    62 Woo
  8. Anton Sebastian Becker
    40 Becker