Can Recurrence-Free or Disease-Free Survival be used Surrogate Endpoints for Overall Survival in Esophageal Cancer?

The answer appears to be ‘yes’ according a recent paper written by Uchechukwu Love Anyaduba, Oluwatosin Qawiyy Orababa, Zion Faye, Nazia Rashid, Gregory Reardon and myself. The abstract is below:

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.

You can read the full article here.

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