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Aleksandra Gara
Author of
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P1.01 - Advanced NSCLC (ID 158)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.01-06 - Comparative Effectiveness of First Line (1L) Therapies for Advanced Non-Small Cell Lung Cancer (aNSCLC): A Systematic Literature Review (SLR) (Now Available) (ID 1982)
09:45 - 18:00 | Author(s): Aleksandra Gara
- Abstract
Background
The therapeutic landscape for aNSCLC has shifted in recent years. Novel therapies, including immunotherapies, have been tested in clinical trials but less is known about their effectiveness and safety in real-world (RW) settings. Our primary objective was to quantify the relative effectiveness and safety of 1L therapies for aNSCLC in a RW setting.
Method
An SLR was conducted using EMBASE and MEDLINE (2012-2018), alongside searches of conference proceedings (2015-2018). Two reviewers assessed eligibility and included observational studies involving at least two chemotherapy or immunotherapy-based 1L therapies for aNSCLC. EGFR+, ALK+, and KRAS+ mutation-targeting therapies and sub-populations were excluded. Effectiveness and safety endpoints were extracted; relative effects were presented using forest plots. Pooled estimates were not generated due to study design heterogeneity and limited number of studies per treatment comparison. Risk of bias was assessed using ROBINS-I.
Result
From 4,307 abstracts, 18 RW chemotherapy-based studies were included; no immunotherapy-based studies were identified. Of the 18 studies, only seven used methods to balance patient characteristics across treatments. Of these seven, relative effect estimates trended toward improved overall survival (OS) and progression-free survival (PFS) associated with chemotherapy doublets involving pemetrexed, nab-paclitaxel, or the addition of bevacizumab, relative to older platinum-based chemotherapy doublets (Figure 1). Significantly higher objective response rates (ORR) were observed for pemetrexed-based doublets relative to paclitaxel- and gemcitabine-based doublets reported in one multi-group study. There were no significant differences in non-hematologic and few significant differences in hematologic adverse event rates.
Conclusion
This SLR provides complementary evidence showing relative effect sizes of 1L chemotherapies in the RW setting, which were broadly consistent with those observed in clinical trials. Comparative RW evidence for immunotherapies in 1L aNSCLC is lacking and is expected to emerge in the future; however, this research provides a benchmark against which new evidence can be compared.
