In Reply We thank Yuji and Li for their comments on the MELATORCH trial. We agree with the main point: the median progression-free survival (PFS) difference was small.
However, a comparison of the treatment effect that considers only median survival time, a point estimate, is not sufficient to fully characterize the overall treatment effects. The MELATORCH study has evaluated the magnitude of efficacy by comparing the differences over the entire survival curves between the treatment arms, which is statistically measured by the hazard ratio (HR), its 95% CI from the Cox proportional hazards model, and the P value from the log-rank test.
From the PFS Kaplan-Meier curves, the 2 treatment arms clearly separated after the median and the separation was sustained, demonstrating a statistically significant improvement in PFS of toripalimab over dacarbazine (HR, 0.71; 95% CI, 0.53-0.95; P = .02).
JAMA Oncology published a clinical update in Oncology on 09 Apr 2026.
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