Evaluation of tumor response, disease control, progression-free survival, and time to progression as potential surrogate end points in metastatic breast cancer.

PURPOSE: Overall survival (OS) can be observed only after prolonged follow-up, and any potential effect of first-line therapies on OS may be confounded by the effects of subsequent therapy. We investigated whether tumor response, disease control, progression-free survival (PFS), or time to progression (TTP) could be considered a valid surrogate for OS to assess the benefits of first-line therapies for patients with metastatic breast cancer. PATIENTS AND METHODS: Individual patient data were collected on 3,953 patients in 11 randomized trials that compared an anthracycline (alone or in combination) with a taxane (alone or in combination with an anthracycline). Surrogacy was assessed through the correlation between the end points as well as through the correlation between the treatment effects on the end points. RESULTS: Tumor response (survival odds ratio [OR], 6.2; 95% CI, 5.3 to 7.0) and disease control (survival OR, 5.5; 95% CI, 4.8 to 6.3) were strongly associated with OS. PFS (rank correlation coefficient, 0.688; 95% CI, 0.686 to 0.690) and TTP (rank correlation coefficient, 0.682; 95% CI, 0.680 to 0.684) were moderately associated with OS. Response log ORs were strongly correlated with PFS log hazard ratios (linear coefficient [rho], 0.96; 95% CI, 0.73 to 1.19). Response and disease control log ORs and PFS and TTP log hazard ratios were poorly correlated with log hazard ratios for OS, but the confidence limits of rho were too wide to be informative. CONCLUSION: No end point could be demonstrated as a good surrogate for OS in these trials. Tumor response may be an acceptable surrogate for PFS.

We want to touch IT. Are hybrid laptops just new fancy gadgets or a new revolution?

While the number of traditional laptops and computers sold has dipped slightly year over year, manufacturers have developed new hybrid laptops with touch screens to build on the tactile trend. This market is moving quickly to make touch the rule rather than the exception and the sales of these devices have tripled since the launch of Windows 8 in 2012, to reach more than sixty million units sold in 2015. Unlike tablets, that benefit from easy-to-use applications specially designed for tactile interactions, hybrid laptops are intended to be used with regular user-interfaces. Hence, one could ask whether tactile interactions are suited for every task and activity performed with such interfaces. Since hybrid laptops are increasingly used in educational situations, this study focuses on information search tasks which are commonly performed for learning purposes. It is hypothesized that tasks that require complex and/or less common gestures will increase user's cognitive load and impair task performance in terms of efficacy and efficiency. A study was carried out in a usability laboratory with 30 participants for whom prior experience with tactile devices has been controlled. They were asked to perform information search tasks on an online encyclopaedia by using only the touch screen of and hybrid laptop. Tasks were selected with respect to their level of cognitive demand (amount of information that had to be maintained in working memory) and the complexity of gestures needed (left and/or right clicks, zoom, text selection and/or input.), and grouped into 4 sets accordingly. Task performance was measured by the number of tasks succeeded (efficacy) and time spent on each task (efficiency). Perceived cognitive load was assessed thanks to a questionnaire given after each set of tasks. An eye tracking device was used to monitor users' attention allocation and to provide objective cognitive load measures based on pupil dilation and the Index of Cognitive Activity. Each experimental run took approximately one hour. The results of this within-subjects design indicate that tasks involving complex gestures led to a lower efficacy, especially when the tasks were cognitively demanding. Regarding efficacy, there is no significant differences between sets of tasks excepted for tasks with low cognitive demand and complex gestures that required more time to be achieved. Surprisingly, users that declared the biggest experience with tactile devices spent more time than less frequent users. Cognitive load measures indicate that participants reported having devoted more mental effort in the interaction when they had to use complex gestures.