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The use of endpoints in phase 3 randomized controlled trials in metastatic breast cancer - PubMed

6 hours ago
  • #metastatic breast cancer
  • #phase 3 RCT
  • #clinical trial endpoints
  • The study analyzed 267 phase 3 randomized controlled trials (RCTs) in metastatic breast cancer started between 2008 and 2025.
  • Progression-free survival (PFS) was the most common primary endpoint (85.4%), while overall survival (OS) was used in only 13.1% of trials.
  • Trials of chemotherapy were less likely to use PFS as the primary endpoint compared to those testing conjugates.
  • OS as a primary endpoint was more likely in trials enrolling patients with triple-negative breast cancer (TNBC) relative to HER2+ BC.
  • Among PFS-based trials with results, the median improvement in PFS was modest at 2.8 months.
  • 81.1% of trials with PFS as the primary endpoint included OS as a secondary endpoint, and 47.4% included quality of life (QoL) as a secondary endpoint.
  • The line of treatment did not significantly impact the odds of using OS as the primary endpoint.
  • The conclusion recommends using OS as the primary endpoint more frequently, especially in TNBC and later-line treatments, and including QoL as a secondary endpoint more often.