To the Editor In their Original Investigation, Del Paggio et al1 state that progression-free survival (PFS) is an unreliable surrogate for overall survival (OS). Progression-free survival hazard ratio (HR) poorly predicts OS HR, and absolute gains in median PFS inaccurately predict OS gains.2 However, gain in PFS half-life is a good predictor of OS gain.2 For example, studies with low crossover with a PFS half-life gain of 4 or more months have an 84% probability of an OS gain of 5 or more months.2
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Stewart DJ, Wheatley-Price P. Randomized Clinical Trials in the Era of Precision Oncology—The Role of End Points, Industry Funding, and Medical Writing Integrity. JAMA Oncol. 2021;7(10):1577–1578. doi:10.1001/jamaoncol.2021.3338
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