OBJECTIVES: Early-stage oncology trials using endpoints such as recurrence-free survival (RFS) and event-free survival (EFS) are becoming more common. While these endpoints may be well-understood by regulatory decisionmakers, considering whether these matter to patients is also important. This study’s objective was to explore perspectives on oncology trial endpoints among Canadians with early-stage breast or lung cancer.

METHODS: Canadians treated for stage I-IIIC breast cancer, or stage IB-IIIA lung cancer, were recruited through CanCertainty and partner networks for web-based semi-structured interviews in early 2024. Participants described their cancer journey and provided perspectives on overall survival (OS), RFS, EFS and pathological complete response (pCR) endpoints. Thematic analysis was used to explore patterns in responses, and alignment of trial endpoints with patient treatment goals, priorities and preferences.

RESULTS: Of 16 participants (12 with breast and 4 with lung cancer), mean age was 51 years and two were male; 14 reported having surgery, 13 systemic therapy, and 7 radiation. All participants valued survival, and most viewed RFS and EFS as reflective of their treatment priorities, including maintaining health-related quality-of-life (HRQoL) and getting back to ‘normal’. Participants placed high value on having treatment options; and equated having more options, with better options. Participants considered evidence of efficacy provided by early endpoints as sufficient to want access to those treatments. While participants generally agreed that achieving pCR was a priority in their own treatment journey, they predominantly valued medium- to long-term outcomes like HRQoL and remaining cancer-free over time. The relative importance of being recurrence free versus maximizing length of life may differ based on recurrence status, prognosis, cancer type and life stage.

CONCLUSIONS: These findings support the relevance and importance of early oncology endpoints to Canadians with lung and breast cancer and highlight their desire for rapid approval of treatments with demonstrated improvements in endpoints like RFS and EFS.