First-line nab-paclitaxel/carboplatin was associated with a significantly improved overall response rate (primary endpoint) versus paclitaxel/carboplatin in a phase III trial of advanced non-small-cell lung cancer (NSCLC). We report the results of an analysis evaluating the correlation of response and the time to response with survival and quality-adjusted outcomes
Using a landmark approach, progression-free survival (PFS), overall survival (OS), and quality-adjusted time without symptoms or toxicity (Q-TWiST) were compared between patients with a confirmed partial or complete response at or before 6 weeks (? 6-week responders) and those without (? 6-week nonresponders). The outcomes were also analyzed in two 12-week landmark analyses: ? 12-week responders versus ? 12-week nonresponders and early responders (? 6 weeks) versus late responders (6-12 weeks) versus ? 12-week nonresponders.
The median OS and PFS for the ? 6-week responders versus ? 6-week nonresponders were 14.5 versus 10.3 months (P < .001) and 5.5 versus 4.5 months (P = .002), respectively. The ? 6-week responders gained 2.1 months of mean Q-TWiST. The median OS and PFS for the ? 12-week responders versus ? 12-week nonresponders were 16.3 versus 8.4 months and 5.3 versus 2.8 months (both P < .001), respectively, and the ? 12-week responders gained 3.2 months of mean Q-TWiST. The median OS was 13.1, 16.6, and 8.4 months (P < .001), the median PFS was 4.1, 6.7, and 2.8 months (P < .001), and the mean Q-TWiST was 10.2, 11.7, and 7.8 months for the early responders, late responders, and ? 12-week nonresponders, respectively. Both early and late responders had significantly longer Q-TWiST compared with the ? 12-week nonresponders (difference, +2.4 and +3.9 months, respectively; P < .05)
These results underscore response as an important surrogate for assessment of long-term treatment outcomes in advanced NSCLC.