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Combining drugs and extending treatment — a PFS end point is not sufficient

Nature Reviews Clinical Oncology volume 14, pages 521522 (2017) | Download Citation

In studies investigating the combination of two or more anticancer drugs that are already approved for independent use, or 'maintenance' regimens, the use of progression-free survival as the end point for approval is inadequate; sequential treatment with the same agents or existing salvage therapies, respectively, might provide an equivalent survival benefit, with lower toxicity, cost, and treatment burden, therefore, the use of an overall survival end point is essential to justify such interventions.

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Author information


  1. Institute of Cancer Policy, King's College London, SE1 9RT, UK.

    • Bishal Gyawali
  2. Division of Hematology Oncology in the Knight Cancer Institute, Oregon Health and Sciences University (OHSU).

    • Vinay Prasad
  3. Department of Public Health and Preventive Medicine, OSHU.

    • Vinay Prasad
  4. Center for Health Care Ethics, OSHU, 3181 South West Sam Jackson Park Road, Portland, Oregon 97239–3098, USA.

    • Vinay Prasad


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Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Vinay Prasad.

Supplementary information

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    Supplementary information S1 (table)

    Selected studies of combination and maintenance therapies in oncology

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