Dr Bishal Gyawali considers arguments against overall survival as the primary end point and shares his view that overall survival should still be the gold standard.

He first argues that although there is seen to be a time limitation of overall survival, if the drug is good then you do not need to wait for the median overall survival to see a significant difference.

Dr Gyawali also shares his feelings on the problem of post-progression therapies that confound overall survival and whether we should test drugs in later lines of therapies first.