Across 73 CTIS-derived lymphoma Phase III endpoint records authorized in 2024–2026, PFS was the dominant primary survival endpoint while OS did not appear as a primary endpoint in the analyzed cohort. OS remained highly visible as a secondary or follow-up endpoint, suggesting that lymphoma Phase III dossiers are using OS mainly as confirmatory survival context rather than as the primary statistical anchor.
PFS appeared as a primary endpoint in 45 of 73 trials (61.6%). OS appeared as a primary endpoint in 0 of 73 trials (0.0%).
The observed pattern is not a balanced OS-versus-PFS split. PFS functions as the main primary survival endpoint, while OS is largely displaced from primary endpoint status in this lymphoma Phase III cohort.
PFS was primary in 34 of 54 2024 trials (63.0%), 8 of 15 2025 trials (53.3%), and 3 of 4 2026 trials (75.0%).
The endpoint pattern does not appear to be a single-year anomaly. PFS remained the main primary survival endpoint across all three authorization years, while OS remained absent as a primary endpoint in each year.
OS was listed as a secondary or follow-up endpoint in 57 of 73 trials (78.1%). This included 42 of 54 trials in 2024, 12 of 15 in 2025, and 3 of 4 in 2026.
OS is not absent from lymphoma Phase III evidence plans; it is repositioned. The dominant pattern is PFS as the primary efficacy endpoint with OS retained as a longer-horizon survival measure.
PFS was primary in 18 of 23 CLL/SLL/Richter trials (78.3%), 14 of 25 aggressive B-cell/DLBCL trials (56.0%), 10 of 15 follicular/mantle/marginal-zone trials (66.7%), and 3 of 10 Hodgkin/cutaneous/other lymphoma trials (30.0%).
The strongest PFS-primary signal appeared in chronic and indolent B-cell lymphoma programs, where disease-control duration is central to trial design. Aggressive and special-population studies showed more endpoint diversification, but still did not shift OS into the primary position.
Among the 28 trials without PFS as a primary endpoint, 17 used response, complete response, ORR, MRD, or PET-response endpoints (60.7%), while 11 used EFS/DFS, safety, infection, composite, or other endpoints (39.3%).
The alternative to PFS was usually not OS. It was most often a more proximal disease-control or response endpoint, particularly CR, ORR, PET-negative response, or MRD-style measurement.
Among 45 PFS-primary trials, 36 defined PFS using progression/relapse or death (80.0%), 31 referenced Lugano-style lymphoma assessment (68.9%), and 19 used BICR/IRC or central review framing (42.2%).
PFS was not used as a vague surrogate label. In most PFS-primary trials it was anchored to progression or death, and frequently paired with lymphoma-specific response criteria or central-review language.
In this 2024–2026 lymphoma Phase III cohort, the practical endpoint hierarchy is clear: PFS is the primary survival endpoint, OS is usually a secondary endpoint, and non-PFS primary endpoints are mainly response- or disease-control-based.
The data suggest an evidence model in which mature survival benefit remains important but is rarely used as the first decision point. Lymphoma Phase III programs appear to prioritize earlier disease-control readouts, with OS retained to contextualize long-term survival rather than to drive the primary analysis.