Dr. Cohen on the Value of PFS as an Endpoint in Head and Neck Cancer

Ezra Cohen, MD, associate director, Moores Cancer Center at the University of California, San Diego, discusses the value of progression-free survival (PFS) as an endpoint in head and neck cancer trials.

With regard to immunotherapy trials in head and neck cancer, investigators have seen improvements in overall survival (OS) without improvements in PFS, says Cohen. There are several explanations for this, he explains. Immunotherapy operates on a different mechanism of action, as such, patients can progress and still derive long-term benefit. The lack of PFS benefit may also suggest that the patients who experience a long-term benefit with immunotherapy are driving the OS curve, adds Cohen.

In addition, subsequent therapy seems to be more effective in patients who have received immunotherapy. This suggests that the benefit with immunotherapy extends beyond the time the agents are discontinued. As such, PFS may not be the best endpoint to use when comparing these agents with cytotoxic agents or targeted therapies, Cohen concludes.