In Advanced/Metastatic Breast Cancer, Is Progression-Free Survival a Surrogate Outcome?
Author(s)
França AC1, Schroeder L1, Padilla M2, Meirelles I3, Silva AS4, Magliano C3, Santos M1
1Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil, 2Instituto Nacional de Cardiologia, Rio de Janeiro , RJ, Brazil, 3Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil, 4Ministério da Saúde, Brasília, Brazil
OBJECTIVES: Progression-free survival (PFS) is considered by some Health Technology Assessment (HTA) agencies as a surrogate outcome for overall survival in patients with advanced or metastatic breast cancer (BC). According to Brazilian Guidelines for the treatment of breast cancer, PFS should not be considered in the decision-making process to incorporate or not a drug as an option in the public health system. This study aims to identify if PFS in patients with BC is considered a significant outcome for decision-makers from international HTA agencies. METHODS: A search was carried out on the websites of the Canadian Agency for Drugs and Technologies in Health (CADTH); the Scottish Medicines Consortium (SMC); National Institute for Health and Care Excellence (NICE); and Pharmaceutical Benefits Advisory Committee (PBAC). The search strategy included keywords related to "patients’ preferences", "progression-free survival" or PFS. RESULTS: Nine recommendation reports that included patients’ preferences were found, from CADTH, SMC, and NICE. Those documents indicate that PFS is an important outcome for patients, as it allows them to keep up their usual activities for a longer period. Besides that, it was identified that patients would be willing to accept adverse events arising from endocrine therapy to postpone the needed for chemotherapy, which is associated with considerable toxicity and reduced quality of life. These HTA agencies seem to consider PFS since all of them have approved drugs associated with PFS gain such as the CDK inhibitors. CONCLUSIONS: The findings of this study reflect the importance of PFS as an outcome that influences HTA agencies’ decisions. Duo this, PFS should not be considered a surrogate outcome for overall survival but as an independent outcome that affects patients’ quality of life.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PCN312
Topic
Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives, Patient Engagement, Patient-reported Outcomes & Quality of Life Outcomes, Stated Preference & Patient Satisfaction
Disease
Oncology