No trend toward overall survival benefit in either trial arm. The PRECEDENT trial was not statistically powered to show a survival advantage and the results of the trial did not indicate a trend toward benefit in either arm (hazard ratio of 1.099 in the intent-to-treat population). While the median overall survival in the EC145 study arm of 14.1 months represented an improvement in relation to historical trials of PLD alone, the PRECEDENT trial PLD control arm had an unprecedented median overall survival of 16.9 months. These results may have been influenced by prognostic factors favoring the PLD control arm. Specifically, the level of sensitivity to post-trial platinum therapy as measured by platinum-free intervals may have been a factor. Patients in the PLD control arm received post trial platinum-based therapy at nearly twice the rate of those in the EC145 study arm, 33% versus 18% respectively. On an adjusted basis, which accounts for potential differences in demographics and prognostic factors such as platinum free intervals, the overall survival hazard ratio in the FR(++) group was 0.495, although the result was not statistically significant. --------
tough sell with the control arm doing better than the test arm, no?