Adjusted Indirect Comparison Using Propensity Score Matching of Osimertinib to Platinum-Based Doublet Chemotherapy in Patients with EGFRm T790M NSCLC Who Have Progressed after EGFR-TKI
Journal
Clinical Drug Investigation
Journal Volume
38
Journal Issue
4
Pages
319-331
Date Issued
2018
Author(s)
Abstract
Background and objective: An adjusted indirect comparison was conducted to assess efficacy outcomes, particularly overall survival (OS), of osimertinib versus platinum-based doublet chemotherapy in patients with epidermal growth factor receptor-mutated (EGFRm) T790M mutation-positive non-small-cell lung cancer (NSCLC) who had progressed following an EGFR tyrosine kinase inhibitor (TKI). Analysis of treatment effect from two separate trials had the potential to more accurately estimate the magnitude of OS benefit due to absence of confounding due to treatment switching from the control arm to the osimertinib arm of the ongoing randomized control trial, AURA3. Methods: Two non-randomized individual datasets were compared: pooled patients from the AURA extension and AURA2 trials (osimertinib 80?mg, n?=?405, with a confirmed T790M mutation using tissue samples), and patients from the control arm of the IMPRESS study (platinum-based doublet chemotherapy, n?=?61, with a confirmed T790M mutation using plasma circulating tumour DNA [ctDNA]). A propensity score-based approach was used to account for differences in baseline demographics and disease characteristics. Results: After adjustment for baseline differences between the two groups, osimertinib demonstrated a statistically significant improvement in progression-free survival (PFS) versus platinum-based doublet chemotherapy (hazard ratio [HR]?=?0.278, 95% confidence interval [CI] 0.188–0.409, p?
SDGs
Other Subjects
antineoplastic metal complex; circulating tumor DNA; cisplatin; epidermal growth factor receptor; epidermal growth factor receptor kinase inhibitor; gefitinib; osimertinib; pemetrexed; antineoplastic agent; epidermal growth factor receptor; osimertinib; piperazine derivative; platinum; protein kinase inhibitor; adult; aged; Article; cancer combination chemotherapy; cancer control; cancer growth; cancer size; comparative effectiveness; controlled study; drug efficacy; drug treatment failure; female; follow up; human; major clinical study; male; non small cell lung cancer; overall survival; phase 2 clinical trial (topic); priority journal; progression free survival; propensity score; randomized controlled trial (topic); treatment response; comparative study; controlled clinical trial; disease free survival; genetics; lung tumor; meta analysis (topic); metabolism; middle aged; mutation; non small cell lung cancer; propensity score; very elderly; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Non-Small-Cell Lung; Disease-Free Survival; Female; Humans; Lung Neoplasms; Male; Meta-Analysis as Topic; Middle Aged; Mutation; Piperazines; Platinum; Propensity Score; Protein Kinase Inhibitors; Receptor, Epidermal Growth Factor
Publisher
Springer International Publishing
Type
journal article