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Kittai AS, Allan JN, James D, Bridge H, Miranda M, Yong ASM, Fam F, Roos J, Shetty V, Skarbnik A, Davids MS. An indirect comparison of acalabrutinib with and without obinutuzumab vs zanubrutinib in treatment-naive CLL. Blood Adv 2024; 8:2861-2869. [PMID: 38598745 PMCID: PMC11176945 DOI: 10.1182/bloodadvances.2023012142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024] Open
Abstract
ABSTRACT The efficacy and safety of acalabrutinib plus obinutuzumab and acalabrutinib monotherapy vs zanubrutinib in patients with treatment-naive chronic lymphocytic leukemia/small lymphocytic lymphoma without del(17p) were compared using an unanchored matching-adjusted indirect comparison. Individual patient-level data from ELEVATE-TN (acalabrutinib plus obinutuzumab, n = 162; acalabrutinib monotherapy, n = 163) were weighted to match published aggregate baseline data from SEQUOIA cohort 1, which excluded patients with del(17p) (zanubrutinib, n = 241), using variables that were prognostic/predictive of investigator-assessed progression-free survival (INV-PFS) in an exploratory Cox regression analysis of ELEVATE-TN. After matching, INV-PFS was longer with acalabrutinib plus obinutuzumab (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.23-0.74) and comparable with acalabrutinib monotherapy (HR, 0.91; 95% CI, 0.53-1.56) vs zanubrutinib. Acalabrutinib monotherapy had significantly lower odds of any grade hypertension vs zanubrutinib (odds ratio [OR], 0.44; 95% CI, 0.20-0.99), whereas acalabrutinib plus obinutuzumab had significantly higher odds of neutropenia (OR, 2.19; 95% CI, 1.33-3.60) and arthralgia (OR, 2.33; 95% CI, 1.37-3.96) vs zanubrutinib. No other significant differences in safety were observed. In summary, acalabrutinib plus obinutuzumab had longer INV-PFS with increased odds of neutropenia and arthralgia than zanubrutinib, whereas acalabrutinib monotherapy had similar INV-PFS with lower odds of any grade hypertension. These trials were registered at www.ClinicalTrials.gov as #NCT02475681 and #NCT03336333.
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MESH Headings
- Humans
- Benzamides/therapeutic use
- Benzamides/administration & dosage
- Benzamides/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/administration & dosage
- Pyrazines/administration & dosage
- Pyrazines/therapeutic use
- Pyrazines/adverse effects
- Female
- Male
- Aged
- Pyrimidines/therapeutic use
- Pyrimidines/administration & dosage
- Pyrimidines/adverse effects
- Pyrazoles/therapeutic use
- Pyrazoles/administration & dosage
- Pyrazoles/adverse effects
- Middle Aged
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Aged, 80 and over
- Treatment Outcome
- Piperidines
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Affiliation(s)
- Adam S. Kittai
- Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Dan James
- Polaris Biostatistics Ltd, Edinburgh, United Kingdom
| | - Helen Bridge
- AstraZeneca, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Miguel Miranda
- AstraZeneca, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | | | - Fady Fam
- AstraZeneca, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | | | | | - Alan Skarbnik
- Novant Health Cancer Institute, Lymphoma and CLL Program, Charlotte, NC
| | - Matthew S. Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
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2
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Cassidy O, Harte M, Trela-Larsen L, Walsh C, White A, McCullagh L, Leahy J. A Comparison of Relative-Efficacy Estimate(S) Derived From Both Matching-Adjusted Indirect Comparisons and Standard Anchored Indirect Treatment Comparisons: A Review of Matching-Adjusted Indirect Comparisons. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1665-1674. [PMID: 37460009 DOI: 10.1016/j.jval.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 06/06/2023] [Accepted: 07/07/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES We present an empirical comparison of relative-efficacy estimate(s) from matching-adjusted indirect comparisons (MAICs) with estimates from corresponding standard anchored indirect treatment comparisons. METHODS A total of 80 comparisons were identified from 17 publications through a systematic rapid review. A standardized metric that used reported relative treatment efficacy estimates and their associated uncertainty was used to compare the methods across different treatment indications and outcome measures. RESULTS On aggregate, MAICs presented for connected networks tended to report a more favorable relative-efficacy estimate for the treatment for which individual-level patient data were available relative to the reported indirect treatment comparison estimate. CONCLUSIONS Although we recognize the importance of MAIC and other population adjustment methods in certain situations, we recommend that results from these analyses are interpreted with caution. Researchers and analysts should carefully consider if MAICs are appropriate where presented and whether MAICs would have added value where omitted.
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Affiliation(s)
- Owen Cassidy
- National Centre for Pharmacoeconomics Ireland, St. James's Hospital, Dublin, Ireland; Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - Marie Harte
- National Centre for Pharmacoeconomics Ireland, St. James's Hospital, Dublin, Ireland; Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - Lea Trela-Larsen
- National Centre for Pharmacoeconomics Ireland, St. James's Hospital, Dublin, Ireland; Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - Cathal Walsh
- Health Research Institute and MACSI, Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Arthur White
- Department of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Laura McCullagh
- National Centre for Pharmacoeconomics Ireland, St. James's Hospital, Dublin, Ireland; Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - Joy Leahy
- National Centre for Pharmacoeconomics Ireland, St. James's Hospital, Dublin, Ireland; Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland.
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3
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Molica S, Allsup D, Polliack A, Giannarelli D. The net clinical benefit of targeted agents in the upfront treatment of elderly/unfit chronic lymphocytic leukemia patients: Results of network meta-analysis. Eur J Haematol 2023; 110:774-777. [PMID: 36786335 DOI: 10.1111/ejh.13943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023]
Affiliation(s)
- Stefano Molica
- Department Haematology, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - David Allsup
- Department Haematology, Hull University Teaching Hospitals NHS Trust, Hull, UK
- Centre for Biomedicine, Hull York Medical School, Hull, UK
| | - Aaron Polliack
- Hadassah University Hospital and Hebrew University Medical School, Jerusalem, Israel
| | - Diana Giannarelli
- Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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Dynamic Bayesian networks for prediction of health status and treatment effect in patients with chronic lymphocytic leukemia. Sci Rep 2022; 12:1811. [PMID: 35110619 PMCID: PMC8810890 DOI: 10.1038/s41598-022-05813-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 01/13/2022] [Indexed: 11/21/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is the most common blood cancer in adults. The course of CLL and patients' response to treatment are varied. This variability makes it difficult to select the most appropriate treatment regimen and predict the progression of the disease. This work was aimed at developing and validating dynamic Bayesian networks (DBNs) to predict changes of the health status of patients with CLL and progression of the disease over time. Two DBNs were developed and implemented i.e. Health Status Network (HSN) and Treatment Effect Network (TEN). Based on the literature data and expert knowledge we identified relationships linking the most important factors influencing the health status and treatment effects in patients with CLL. The developed networks, and in particular TEN, were able to predict probability of survival in patients with CLL, which was in line with the survival data collected in large medical registries. The networks can be used to personalize the predictions, taking into account a priori knowledge concerning a particular patient with CLL. The proposed approach can serve as a basis for the development of artificial intelligence systems that facilitate the choice of treatment that maximizes the chances of survival in patients with CLL.
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Tarhini AA, Toor K, Chan K, McDermott DF, Mohr P, Larkin J, Hodi FS, Lee CH, Rizzo JI, Johnson H, Moshyk A, Rao S, Kotapati S, Atkins MB. A matching-adjusted indirect comparison of combination nivolumab plus ipilimumab with BRAF plus MEK inhibitors for the treatment of BRAF-mutant advanced melanoma ☆. ESMO Open 2021; 6:100050. [PMID: 33556898 PMCID: PMC7872980 DOI: 10.1016/j.esmoop.2021.100050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/18/2020] [Accepted: 01/05/2021] [Indexed: 12/21/2022] Open
Abstract
Background Approved first-line treatments for patients with BRAF V600–mutant advanced melanoma include nivolumab (a programmed cell death protein 1 inhibitor) plus ipilimumab (a cytotoxic T lymphocyte antigen-4 inhibitor; NIVO+IPI) and the BRAF/MEK inhibitors dabrafenib plus trametinib (DAB+TRAM), encorafenib plus binimetinib (ENCO+BINI), and vemurafenib plus cobimetinib (VEM+COBI). Results from prospective randomized clinical trials (RCTs) comparing these treatments have not yet been reported. This analysis evaluated the relative efficacy and safety of NIVO+IPI versus DAB+TRAM, ENCO+BINI, and VEM+COBI in patients with BRAF-mutant advanced melanoma using a matching-adjusted indirect comparison (MAIC). Patients and methods A systematic literature review identified RCTs for DAB+TRAM, ENCO+BINI, and VEM+COBI in patients with BRAF-mutant advanced melanoma. Individual patient-level data for NIVO+IPI were derived from the phase III CheckMate 067 trial (BRAF-mutant cohort) and restricted to match the inclusion/exclusion criteria of the comparator trials. Treatment effects for overall survival (OS) and progression-free survival (PFS) were estimated using Cox proportional hazards and time-varying hazard ratio (HR) models. Safety outcomes (grade 3 or 4 treatment-related adverse events) with NIVO+IPI and the comparators were compared. Results In the Cox proportional hazards analysis, NIVO+IPI showed improved OS compared with DAB+TRAM (HR = 0.53; 95% confidence interval [CI], 0.39-0.73), ENCO+BINI (HR = 0.60; CI, 0.42-0.85), and VEM+COBI (HR = 0.50; CI, 0.36-0.70) for the overall study period. In the time-varying analysis, NIVO+IPI was associated with significant improvements in OS and PFS compared with the BRAF/MEK inhibitors 12 months after treatment initiation. There were no significant differences between NIVO+IPI and BRAF/MEK inhibitor treatment from 0 to 12 months. Safety outcomes favored DAB+TRAM over NIVO+IPI, whereas NIVO+IPI was comparable to VEM+COBI. Conclusion Results of this MAIC demonstrated durable OS and PFS benefits for patients with BRAF-mutant advanced melanoma treated with NIVO+IPI compared with BRAF/MEK inhibitors, with the greatest benefits noted after 12 months. First-line treatments for BRAF V600-mutant melanoma include NIVO+IPI and BRAF/MEK inhibitors. Results from prospective RCTs comparing NIVO+IPI and BRAF/MEK inhibitors have not yet been reported. This MAIC evaluated NIVO+IPI versus BRAF/MEK inhibitors for BRAF-mutant advanced melanoma. OS and PFS benefits were noted with NIVO+IPI versus BRAF/MEK inhibitors beginning at 12 months. These findings may provide information relevant to the selection of treatments for BRAF-mutant advanced melanoma.
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Affiliation(s)
- A A Tarhini
- Departments of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
| | - K Toor
- Evidence Synthesis and Decision Modeling, Precision HEOR, Vancouver, Canada
| | - K Chan
- Evidence Synthesis and Decision Modeling, Precision HEOR, Vancouver, Canada
| | - D F McDermott
- Medical Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA
| | - P Mohr
- Department of Dermatology, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - J Larkin
- Medical Oncology, The Royal Marsden Hospital, London, UK
| | - F S Hodi
- Medical Oncology, Dana-Farber/Harvard Cancer Center, Boston, USA
| | - C-H Lee
- US Health Economics and Outcome Research, Metastatic Melanoma, Bristol Myers Squibb, Princeton, USA
| | - J I Rizzo
- Oncology Clinical Development, Bristol Myers Squibb, Princeton, USA
| | - H Johnson
- Worldwide Health Economics and Outcomes Research, Melanoma, Bristol Myers Squibb, Uxbridge, UK
| | - A Moshyk
- Worldwide Health Economics and Outcomes Research, Melanoma, Bristol Myers Squibb, Princeton, USA
| | - S Rao
- US Health Economics and Outcome Research, Metastatic Melanoma, Bristol Myers Squibb, Princeton, USA
| | - S Kotapati
- Worldwide Medical, Melanoma, Bristol Myers Squibb, Princeton, USA
| | - M B Atkins
- Medical Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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Milunović V, Mišura Jakobac K, Mandac Rogulj I, Martinović M, Radić-Krišto D, Ostojić Kolonić S. The fading star of obinutuzumab-chlorambucil regimen in patients with comorbidities with chronic lymphocytic leukemia - are we ready for chemo-free immunotherapy approach? Expert Rev Hematol 2020; 13:771-779. [PMID: 32579408 DOI: 10.1080/17474086.2020.1775575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Chronic lymphocytic leukemia (CLL) is the most common leukemia in Western countries occurring typically in elderly patients. These patients often present with comorbidities limiting treatment options. During the last decade, the treatment paradigm has rapidly changed with the introduction of novel oral targeted agents and monoclonal antibodies. AREAS COVERED The review focuses on the combination of type II antiCD20 antibody obinutuzumab in combination with chemotherapy or oral targeted agents in patients not suited for fludarabine-based therapy because of comorbidities or age. The main focus of the review is whether classical immunochemotherapy with obinutuzumab-chlorambucil is still a valid therapeutic option or whether the combination of obinutuzumab and ibrutinib or venetoclax presents novel standard of care. EXPERT OPINION Both pivotal and registrational studies iLLLUMINATE study testing the combination of ibrutinib and obinutuzumab and CLL14 study testing the fixed combination of venetoclax and obinutuzumab have shown major benefit over chemoimmunotherapy approach in this population. Furthermore, they have excellent activity in high-risk subgroups of CLL paving the road toward a chemo-free immunotherapy approach in this setting. However, there are some pitfalls in these strategies warranting further research.
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Affiliation(s)
- Vibor Milunović
- Division of Hematology, Clinical Department of Internal Diseases, Clinical Hospital Merkur , Zagreb, Croatia
| | - Karla Mišura Jakobac
- Division of Hematology, Clinical Department of Internal Diseases, Clinical Hospital Merkur , Zagreb, Croatia
| | - Inga Mandac Rogulj
- Division of Hematology, Clinical Department of Internal Diseases, Clinical Hospital Merkur , Zagreb, Croatia
| | - Marko Martinović
- Division of Hematology, Clinical Department of Internal Diseases, Clinical Hospital Merkur , Zagreb, Croatia
| | - Delfa Radić-Krišto
- Division of Hematology, Clinical Department of Internal Diseases, Clinical Hospital Merkur , Zagreb, Croatia.,School of Medicine in Osijek, Josip Juraj Strossmajer University in Osijek , Osijek, Croatia
| | - Slobodanka Ostojić Kolonić
- Division of Hematology, Clinical Department of Internal Diseases, Clinical Hospital Merkur , Zagreb, Croatia.,School of Medicine in Zagreb, University of Zagreb , Zagreb, Croatia
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7
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Mateos MV, San-Miguel J, Goldschmidt H, Sonneveld P, Dimopoulos MA, Heeg B, Hashim M, Deraedt W, Hu P, Lam A, He J. The effects of different schedules of bortezomib, melphalan, and prednisone for patients with newly diagnosed multiple myeloma who are transplant ineligible: a matching-adjusted indirect comparison. Leuk Lymphoma 2019; 61:680-690. [PMID: 31686561 DOI: 10.1080/10428194.2019.1675881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
For patients with newly diagnosed multiple myeloma (NDMM) who are transplant ineligible, bortezomib-melphalan-prednisone (VMP) demonstrated superior efficacy based on the VISTA trial. In subsequent trials, twice-weekly bortezomib was limited to the first cycle or completely replaced with once-weekly bortezomib to reduce toxicity. Following a systematic literature review, the efficacy and safety of modified VMP schedules (pooled data from the once-weekly bortezomib VMP arm of the GIMEMA trial and the VMP arm of the ALCYONE trial) were compared to the VISTA schedule using naïve and unanchored matching-adjusted indirect comparison (MAIC). Median progression-free survival was similar between VISTA and modified VMP (20.7 months [95% CI, 18.4-24.3] vs 19.6 months [95% CI, 18.8-21.0]). Peripheral neuropathy was significantly reduced with modified VMP versus VISTA VMP (all grades: naïve, 32.1% vs 46.8% and MAIC, 32.1% vs 46.7%; both p < .0001). These findings support a modified VMP dosing schedule for patients with NDMM who are transplant ineligible.
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Affiliation(s)
| | - Jesus San-Miguel
- Clínica Universidad de Navarra-CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - Hartmut Goldschmidt
- Internal Medicine V and National Center of Tumor Diseases (NCT), University Clinic Heidelberg, Heidelberg, Germany
| | - Pieter Sonneveld
- Department of Haematology, Erasmus MC, Rotterdam, The Netherlands
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Bart Heeg
- Ingress Health, Rotterdam, The Netherlands
| | | | - William Deraedt
- Oncology R&D, Janssen Research & Development, Beerse, Belgium
| | - Peter Hu
- Statistical Programming (Haematology), Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Annette Lam
- Global Market Access and Health Policy, Janssen Global Services, LLC, Raritan, NJ, USA
| | - Jianming He
- Global Market Access and Health Policy, Janssen Global Services, LLC, Raritan, NJ, USA
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Tedeschi A, Greil R, Demirkan F, Robak T, Moreno C, Barr PM, Anz B, Simpson D, Gaidano G, Bairey O, Stevens D, Gill D, Flinn IW, Kipps TJ, Burger JA, Lin J, Webb T, Fedorov V, Styles L, Gribben JG. A cross-trial comparison of single-agent ibrutinib versus chlorambucil-obinutuzumab in previously untreated patients with chronic lymphocytic leukemia or small lymphocytic lymphoma. Haematologica 2019; 105:e164-e168. [PMID: 31413095 DOI: 10.3324/haematol.2019.223743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Richard Greil
- Paracelsus Medical University Salzburg, Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Salzburg, Austria
| | | | - Tadeusz Robak
- Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | - Carol Moreno
- Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Paul M Barr
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | - Osnat Bairey
- Rabin Medical Center, Beilinson Hospital and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Don Stevens
- Norton Cancer Institute, Louisville, KY, USA
| | | | - Ian W Flinn
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, USA
| | - Thomas J Kipps
- University of California, San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Jan A Burger
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer Lin
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | | | - Viktor Fedorov
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | - Lori Styles
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | - John G Gribben
- Barts Cancer Institute, Queen Mary University of London, London, UK
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Xu Y, Fahrbach K, Dorman E, Baculea S, Côté S, Sanden SV, Diels J. Front-line treatment of patients with chronic lymphocytic leukemia: a systematic review and network meta-analysis. J Comp Eff Res 2018; 7:421-441. [DOI: 10.2217/cer-2017-0086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: A systematic literature review and network meta-analysis were conducted to determine the relative efficacy and safety of interventions for treatment-naive chronic lymphocytic leukemia patients, as comparative evidence is scarce. Materials & methods: Relative treatment effects of progression-free survival, overall survival and safety outcomes were estimated via network meta-analysis based on data identified via systematic literature review. Results: Ibrutinib was superior in all pairwise comparisons for progression-free survival (probability to be better [P] range: overall population: 69–100%; fludarabine-ineligible population: 69–100%) and overall survival (P range: overall: 89–100%; fludarabine-ineligible: 91–100%) and had the highest probability of being best for all outcomes. Conclusion: Ibrutinib provides superior benefit in survival and safety compared with other front-line treatments of chronic lymphocytic leukemia.
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Sinha R, Redekop WK. Cost-Effectiveness of Ibrutinib Compared With Obinutuzumab With Chlorambucil in Untreated Chronic Lymphocytic Leukemia Patients With Comorbidities in the United Kingdom. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:e131-e142. [DOI: 10.1016/j.clml.2017.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
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