NPJ Precis Oncol. 2025 Dec 15. doi: 10.1038/s41698-025-01231-x. Online ahead of print.
ABSTRACT
Progression Free Survival Ratio (PFSratio), as defined as the ratio between PFS on investigational treatment (PFS2) and PFS on the last prior therapy (PFS1), is a popular endpoint in precision oncology (PO) studies. In this work, five methodologies for PFSratio-based trial analysis (count-based, Kaplan Meier, Kernel-based Kaplan Meier, parametric and midrank) and two for trial design (GBVE and Weibull) are benchmarked. The Kernel-based Kaplan Meier analysis is most recommended, as it handles informative censoring and does not require PFS1/PFS2 distribution assumptions. Sample size and power calculation methods perform best when applied to settings with expected high PFS1/PFS2 correlation and median ratio. Analysis of five clinical trials (MOSCATO 01, WINTHER, MASTER, SHIVA and POG570) from >800 patients revealed an overall weak PFS1/PFS2 correlation (Kendall's τ range 0.17-0.35), and an asymptotically unbiased median S(δ=1.3) = 33% by means of the Kernel-based analysis, while other methods considerably deviated in studies with censoring rate>10%. This methodology is implemented in the PROPHETS R package and Shiny app.
PMID:41398053 | DOI:10.1038/s41698-025-01231-x