# Progression-free survival (PFS)

Source: https://onco.cc/terms/pfs/  
OnCo record `pfs` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Progression-free survival (PFS) is how long patients live without their cancer growing.

## Summary

Progression-free survival (PFS) measures the time from random assignment until the cancer progresses or the patient dies, whichever comes first. It is a common primary endpoint because a trial can read out with fewer patients and in less time than one powered for overall survival, but a PFS gain does not always translate into an OS benefit, as TROPION-Breast01 illustrated; PFS2 tracks progression on the next therapy. PFS is referenced by the Small-cell lung cancer, Sarcomas and Hodgkin lymphoma entries, the POLARIX trial and Michael LeBlanc, and it features in the bottlenecks on trial design, real-world evidence and quality of life. Ideas engaging with it include clonal clearance as an endpoint, a six-week ctDNA switch and seamless phase 2/3 designs with pre-registered go rules.

## Fields

- Kind: Term
- Last checked: 2026-09-04
- Also known as: progression-free; mPFS; progression or death

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Progression-free_survival
- Wikipedia: https://en.wikipedia.org/wiki/Progression-free_survival

## Connected records

- terms: [Blinded independent central review (BICR)](https://onco.cc/terms/bicr/), [Clinical benefit response (the gemcitabine trial endpoint)](https://onco.cc/terms/clinical-benefit-response/), [Crossover in trials](https://onco.cc/terms/crossover/), [Duration of response](https://onco.cc/terms/duration-of-response/), [Duration of response (DoR) and disease control rate (DCR)](https://onco.cc/terms/duration-of-response-term/), [Endpoint](https://onco.cc/terms/endpoint/), [Estimands and intercurrent events (ICH E9(R1))](https://onco.cc/terms/estimand/), [Hazard ratio (HR)](https://onco.cc/terms/hazard-ratio/), [Kaplan-Meier curve, censoring and proportional hazards](https://onco.cc/terms/kaplan-meier-curve/), [Landmark and milestone survival (5-year survival, median follow-up)](https://onco.cc/terms/landmark-survival/), [Maintenance therapy](https://onco.cc/terms/maintenance-therapy/), [Median survival](https://onco.cc/terms/median-survival/), [Overall survival (OS)](https://onco.cc/terms/os/), [Primary, secondary and co-primary endpoints](https://onco.cc/terms/primary-endpoint/), [Progression](https://onco.cc/terms/progression/), [Progressive disease and radiographic progression](https://onco.cc/terms/progressive-disease/), [Reading a hazard ratio](https://onco.cc/terms/hazard-ratio-basics/), [RECIST](https://onco.cc/terms/recist/), [Stable disease](https://onco.cc/terms/stable-disease/), [Surrogate endpoint](https://onco.cc/terms/surrogate-endpoint/), [Surrogate endpoint validation: which stand-ins have earned trust](https://onco.cc/terms/surrogate-validation/), [Survival outcomes as time plus event (OS, PFS)](https://onco.cc/terms/os-pfs-time-event/), [Time to progression (TTP) and time to next treatment (TTNT)](https://onco.cc/terms/ttp/), [Why trials fail: underpowered, wrong endpoint, control arm drift, subgroup fishing, crossover](https://onco.cc/terms/trial-failure-modes/)
- trials: [CheckMate 9ER](https://onco.cc/trials/checkmate-9er/), [CodeBreaK 200](https://onco.cc/trials/codebreak-200/), [CUPISCO](https://onco.cc/trials/cupisco/), [ECOG-ACRIN E3311](https://onco.cc/trials/ecog-e3311/), [ERGO2: ketogenic diet and fasting during re-irradiation of recurrent glioma](https://onco.cc/trials/ergo2/), [Gefitinib vs gefitinib plus pemetrexed-carboplatin in EGFR-mutant lung cancer (Tata Memorial)](https://onco.cc/trials/gefitinib-chemo-tmh/), [POLARIX](https://onco.cc/trials/polarix/), [TROPION-Breast01](https://onco.cc/trials/tropion-breast01/)
- cancers: [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/)
- key papers: [ADRIATIC: durvalumab after chemoradiotherapy for limited-stage small-cell lung cancer](https://onco.cc/key-papers/paper-adriatic-nejm-2024/), [AMPLIFY: fixed-duration acalabrutinib plus venetoclax, with or without obinutuzumab, versus chemo-immunotherapy in fit CLL patients](https://onco.cc/key-papers/paper-amplify-acalabrutinib-venetoclax-nejm-2025/), [ASCENT: sacituzumab govitecan doubles survival in heavily pretreated metastatic triple-negative breast cancer](https://onco.cc/key-papers/paper-ascent-nejm-2021/), [BREAKWATER: encorafenib plus cetuximab with chemotherapy as first treatment for BRAF V600E-mutated colorectal cancer](https://onco.cc/key-papers/paper-breakwater-nejm-2025/), [Capivasertib plus paclitaxel as first-line treatment for metastatic triple-negative breast cancer: results from the randomised, global phase III CAPItello-290 trial](https://onco.cc/key-papers/paper-capitello-290-capivasertib-paclitaxel-ann-oncol-2026/), [CARTITUDE-4: cilta-cel CAR-T versus standard combinations after one to three prior lines of myeloma therapy](https://onco.cc/key-papers/paper-cartitude-4-cilta-cel-nejm-2023/), [CEPHEUS: daratumumab quadruplet for newly diagnosed myeloma patients not having a transplant, with MRD-negativity as the main endpoint](https://onco.cc/key-papers/paper-cepheus-dara-vrd-natmed-2025/), [CheckMate 649: nivolumab plus chemotherapy as first treatment for advanced gastric, gastro-oesophageal junction and oesophageal adenocarcinoma](https://onco.cc/key-papers/paper-checkmate-649-lancet-2021/), [CLEAR: lenvatinib plus pembrolizumab versus sunitinib as first treatment for advanced kidney cancer](https://onco.cc/key-papers/paper-clear-nejm-2021/), [CLL14: one year of venetoclax plus obinutuzumab instead of chemo-immunotherapy in older, less fit CLL patients](https://onco.cc/key-papers/paper-cll14-venetoclax-obinutuzumab-nejm-2019/), [CodeBreaK 200: sotorasib versus docetaxel in KRAS G12C-mutated lung cancer, a modest win for the first KRAS drug](https://onco.cc/key-papers/paper-codebreak-200-lancet-2023/), [CodeBreaK 300: sotorasib plus panitumumab in chemotherapy-refractory KRAS G12C colorectal cancer](https://onco.cc/key-papers/paper-codebreak-300-nejm-2023/), [Conroy 2011: FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer (PRODIGE 4/ACCORD 11)](https://onco.cc/key-papers/paper-conroy-folfirinox-pancreatic-nejm-2011/), [Datopotamab deruxtecan in patients with untreated, advanced triple-negative breast cancer (TROPION-Breast02): a randomised, open-label, international, phase III trial](https://onco.cc/key-papers/paper-tropion-breast02-ann-oncol-2026/), [DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer](https://onco.cc/key-papers/paper-destiny-breast03-nejm-2022/), [DESTINY-Breast04: trastuzumab deruxtecan works in HER2-low breast cancer, creating a new treatable group](https://onco.cc/key-papers/paper-destiny-breast04-nejm-2022/), [DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer](https://onco.cc/key-papers/paper-destiny-breast06-nejm-2024/), [ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma](https://onco.cc/key-papers/paper-echelon-1-brentuximab-avd-nejm-2018/), [ELEVATE-TN: acalabrutinib, alone or with obinutuzumab, against chemo-immunotherapy in untreated CLL](https://onco.cc/key-papers/paper-elevate-tn-acalabrutinib-lancet-2020/), [EV-302: enfortumab vedotin plus pembrolizumab replaces chemotherapy as first treatment for advanced bladder cancer](https://onco.cc/key-papers/paper-ev-302-nejm-2024/), [First-line lorlatinib or crizotinib in advanced ALK-positive lung cancer](https://onco.cc/key-papers/paper-shaw-crown-lorlatinib-crizotinib-nejm-2020/), [FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer](https://onco.cc/key-papers/paper-flaura-nejm-2018/), [HARMONi-2: ivonescimab, a PD-1 x VEGF bispecific, beats pembrolizumab head-to-head in PD-L1-positive lung cancer](https://onco.cc/key-papers/paper-harmoni-2-lancet-2025/), [Hurwitz 2004: bevacizumab with chemotherapy for metastatic colorectal cancer, the first anti-angiogenic drug to extend life](https://onco.cc/key-papers/paper-hurwitz-bevacizumab-crc-nejm-2004/), [IMbrave150: atezolizumab plus bevacizumab replaces sorafenib as first treatment for advanced liver cancer](https://onco.cc/key-papers/paper-imbrave150-nejm-2020/), [INDIGO: vorasidenib, the first targeted drug for IDH-mutant low-grade glioma](https://onco.cc/key-papers/paper-indigo-nejm-2023/), [IRIS: imatinib versus interferon plus cytarabine as first treatment for chronic myeloid leukaemia](https://onco.cc/key-papers/paper-iris-imatinib-nejm-2003/), [KarMMa-3: ide-cel CAR-T versus standard regimens in triple-class-exposed relapsed myeloma](https://onco.cc/key-papers/paper-karmma-3-ide-cel-nejm-2023/), [KEYNOTE-006 (Robert 2015): pembrolizumab versus ipilimumab in advanced melanoma](https://onco.cc/key-papers/paper-keynote-006-pembrolizumab-ipilimumab-melanoma-nejm-2015/), [KEYNOTE-024: pembrolizumab alone beats chemotherapy in PD-L1-high lung cancer](https://onco.cc/key-papers/paper-keynote-024-nejm-2016/), [KEYNOTE-048: pembrolizumab, alone or with chemotherapy, as first treatment for recurrent or metastatic head and neck cancer](https://onco.cc/key-papers/paper-keynote-048-lancet-2019/), [KEYNOTE-177: pembrolizumab instead of chemotherapy as first treatment for mismatch-repair-deficient metastatic colorectal cancer](https://onco.cc/key-papers/paper-keynote-177-nejm-2020/), [KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation](https://onco.cc/key-papers/paper-keynote-189-nejm-2018/), [KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancer (overall survival)](https://onco.cc/key-papers/paper-keynote-a18-os-lancet-2024/), [KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancer (progression-free survival)](https://onco.cc/key-papers/paper-keynote-a18-pfs-lancet-2024/), [Liposomal irinotecan plus fluorouracil and leucovorin versus fluorouracil and leucovorin for metastatic biliary tract cancer after progression on gemcitabine plus cisplatin (NIFTY): a multicentre, open-label, randomised, phase 2b study](https://onco.cc/key-papers/paper-nifty-liposomal-irinotecan-lancet-oncol-2021/), [MAIA: adding daratumumab to lenalidomide-dexamethasone for older patients with newly diagnosed myeloma who cannot have a transplant](https://onco.cc/key-papers/paper-maia-daratumumab-rd-nejm-2019/), [MARIPOSA: amivantamab plus lazertinib versus osimertinib as first treatment for EGFR-mutated lung cancer](https://onco.cc/key-papers/paper-mariposa-nejm-2024/), [MPACT (Von Hoff 2013): nab-paclitaxel plus gemcitabine for metastatic pancreatic cancer](https://onco.cc/key-papers/paper-mpact-nab-paclitaxel-gemcitabine-nejm-2013/), [MURANO: two years of venetoclax plus rituximab versus chemo-immunotherapy in relapsed CLL](https://onco.cc/key-papers/paper-murano-venetoclax-rituximab-nejm-2018/), [NAPOLI-3: NALIRIFOX versus gemcitabine plus nab-paclitaxel as first treatment for metastatic pancreatic cancer](https://onco.cc/key-papers/paper-napoli-3-lancet-2023/), [NETTER-2: lutetium-177 dotatate as first treatment for higher-grade gastroenteropancreatic neuroendocrine tumours](https://onco.cc/key-papers/paper-netter-2-lancet-2024/), [PACIFIC: a year of durvalumab after chemoradiotherapy for stage III lung cancer](https://onco.cc/key-papers/paper-pacific-nejm-2017/), [PAOLA-1: olaparib added to bevacizumab maintenance in newly diagnosed ovarian cancer, with benefit confined to HRD-positive tumours](https://onco.cc/key-papers/paper-paola-1-nejm-2019/), [PERSEUS: daratumumab added to bortezomib-lenalidomide-dexamethasone around autologous transplant in newly diagnosed myeloma](https://onco.cc/key-papers/paper-perseus-dara-vrd-transplant-nejm-2024/), [POLARIX: swapping vincristine for the antibody-drug conjugate polatuzumab vedotin in first-line treatment of diffuse large B-cell lymphoma](https://onco.cc/key-papers/paper-polarix-polatuzumab-rchp-nejm-2022/), [Prasad: most surrogate endpoints in cancer trials correlate poorly with survival](https://onco.cc/key-papers/paper-prasad-surrogate-endpoints-jama-im-2015/), [RELATIVITY-047: relatlimab plus nivolumab, the first LAG-3 checkpoint combination, in untreated advanced melanoma](https://onco.cc/key-papers/paper-relativity-047-nejm-2022/), [Rohaas 2022: the first randomised trial of TIL therapy, against ipilimumab, in advanced melanoma](https://onco.cc/key-papers/paper-rohaas-til-vs-ipilimumab-nejm-2022/), [RUBY: dostarlimab with chemotherapy for advanced or recurrent endometrial cancer](https://onco.cc/key-papers/paper-ruby-nejm-2023/), [SOLO-1: two years of olaparib maintenance after first-line chemotherapy for BRCA-mutated ovarian cancer](https://onco.cc/key-papers/paper-solo-1-nejm-2018/), [SPOTLIGHT: zolbetuximab, the first Claudin 18.2 antibody, added to chemotherapy in gastric cancer](https://onco.cc/key-papers/paper-spotlight-lancet-2023/), [SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults](https://onco.cc/key-papers/paper-swog-s1826-nivolumab-avd-nejm-2024/), [TROPION-Breast01 China cohort: datopotamab deruxtecan versus chemotherapy in previously treated HR-positive, HER2-negative breast cancer](https://onco.cc/key-papers/paper-tropion-breast01-china-cohort-esmo-open-2026/), [TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival](https://onco.cc/key-papers/paper-tropion-breast01-jco-2024/), [Tumor Treating Fields With Gemcitabine and Nab-Paclitaxel for Locally Advanced Pancreatic Adenocarcinoma: Randomized, Open-Label, Pivotal Phase III PANOVA-3 Study](https://onco.cc/key-papers/paper-panova-3-ttfields-locally-advanced-pancreatic-jco-2025/), [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://onco.cc/key-papers/paper-vision-nejm-2021/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)
- ideas: [A randomised trial of antibody-drug conjugate sequence in metastatic triple-negative breast cancer](https://onco.cc/ideas/idea-tnbc-adc-sequencing-trial/), [AI-assisted central imaging reads to cut endpoint cost and variability](https://onco.cc/ideas/idea-tr1-ai-central-imaging-reads/), [An independent programme that validates surrogate endpoints, setting by setting](https://onco.cc/ideas/idea-tr1-surrogate-validation-programme/), [Deposit trial results as structured data, not just PDFs](https://onco.cc/ideas/idea-data-structured-trial-results-deposit/), [Kill combination arms early using circulating tumour DNA, before waiting for scans](https://onco.cc/ideas/idea-tr2-ctdna-futility-gates/), [Launch prices indexed to the ESMO benefit scale, revisited when survival matures](https://onco.cc/ideas/idea-fund-mcbs-linked-pricing/), [Make clonal clearance, not tumour shrinkage, a trial endpoint](https://onco.cc/ideas/idea-bio1-clonal-clearance-endpoint/), [Open, benchmarked algorithms for lines of therapy and progression from routine data](https://onco.cc/ideas/idea-data-open-line-of-therapy-algorithms/), [Patent term extension scaled to proven survival gain](https://onco.cc/ideas/idea-fund-value-based-patent-extension/), [Power trials to detect a benefit patients would value, not the smallest detectable one](https://onco.cc/ideas/idea-tr1-power-for-meaningful-benefit/), [Provisional prices for surrogate-endpoint approvals, reset when survival data arrive](https://onco.cc/ideas/idea-reg-provisional-price-until-os/), [Publish the disagreement between trial doctors and independent reviewers for every trial](https://onco.cc/ideas/idea-tr2-bicr-discordance-public/), [Report time toxicity, the days a treatment consumes, in every trial and decision aid](https://onco.cc/ideas/idea-moon-time-toxicity-reporting/), [Report time toxicity, the days spent in healthcare, as a standard outcome for older patients](https://onco.cc/ideas/idea-acc-time-toxicity-reporting/), [Require a randomised phase 2 before any phase 3](https://onco.cc/ideas/idea-tr1-randomised-phase-2-before-phase-3/), [Seamless phase 2/3 with pre-registered go rules as the default for new agents](https://onco.cc/ideas/idea-tr1-seamless-2-3-with-prespecified-go/), [Structured, coded radiology reports for cancer response instead of free text](https://onco.cc/ideas/idea-data-structured-radiology-response/), [Time to treatment failure and quality of life as co-primary endpoints in non-curative trials](https://onco.cc/ideas/idea-tr1-ttf-and-qol-coprimary/), [Tolerability as a co-primary endpoint with its own label claim](https://onco.cc/ideas/idea-moon-toxicity-first-endpoints/), [Use a blood test at six weeks to decide whether to keep going](https://onco.cc/ideas/idea-bio2-ctdna-six-week-io-switch/), [Validate real-world progression against central imaging review](https://onco.cc/ideas/idea-data-rwpfs-validation-programme/), [Validate real-world progression endpoints so pragmatic trials can use them](https://onco.cc/ideas/idea-tr1-validate-real-world-progression-endpoints/), [Win-ratio endpoints that weigh survival, toxicity and quality of life together](https://onco.cc/ideas/idea-tr1-win-ratio-net-benefit-endpoint/)
- people: [Michael LeBlanc](https://onco.cc/people/michael-leblanc/)
- bottlenecks: [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/), [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/), [Weak real-world evidence and registries](https://onco.cc/bottlenecks/b-real-world-evidence/)
- collections: [NICE cancer guidance and technology appraisals (UK)](https://onco.cc/collections/nice-guidance/)
- institutions: [Gemeinsamer Bundesausschuss / IQWiG](https://onco.cc/institutions/g-ba-iqwig/), [ISPOR (The Professional Society for Health Economics and Outcomes Research)](https://onco.cc/institutions/ispor/), [National Institute for Health and Care Excellence](https://onco.cc/institutions/nice/)

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