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Preusser M, Kazda T, Le Rhun E, Sahm F, Smits M, Gempt J, Koekkoek JA, Monti AF, Csanadi M, Pitter JG, Bulbek H, Fournier B, Quoilin C, Gorlia T, Weller M, Minniti G. Lomustine with or without reirradiation for first progression of glioblastoma, LEGATO, EORTC-2227-BTG: study protocol for a randomized phase III study. Trials 2024; 25:366. [PMID: 38849943 PMCID: PMC11157762 DOI: 10.1186/s13063-024-08213-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Chemotherapy with lomustine is widely considered as standard treatment option for progressive glioblastoma. The value of adding radiotherapy to second-line chemotherapy is not known. METHODS EORTC-2227-BTG (LEGATO, NCT05904119) is an investigator-initiated, pragmatic (PRECIS-2 score: 34 out of 45), randomized, multicenter phase III trial in patients with first progression of glioblastoma. A total of 411 patients will be randomized in a 1:1 ratio to lomustine (110 mg/m2 every 6 weeks) or lomustine (110 mg/m2 every 6weeks) plus radiotherapy (35 Gy in 10 fractions). Main eligibility criteria include histologic confirmation of glioblastoma, isocitrate dehydrogenase gene (IDH) wild-type per WHO 2021 classification, first progression at least 6 months after the end of prior radiotherapy, radiologically measurable disease according to RANO criteria with a maximum tumor diameter of 5 cm, and WHO performance status of 0-2. The primary efficacy endpoint is overall survival (OS) and secondary endpoints include progression-free survival, response rate, neurocognitive function, health-related quality of life, and health economic parameters. LEGATO is funded by the European Union's Horizon Europe Research program, was activated in March 2024 and will enroll patients in 43 sites in 11 countries across Europe with study completion projected in 2028. DISCUSSION EORTC-2227-BTG (LEGATO) is a publicly funded pragmatic phase III trial designed to clarify the efficacy of adding reirradiation to chemotherapy with lomustine for the treatment of patients with first progression of glioblastoma. TRIAL REGISTRATION ClinicalTrials.gov NCT05904119. Registered before start of inclusion, 23 May 2023.
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Affiliation(s)
- Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Tomáš Kazda
- Department of Radiation Oncology and Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Emilie Le Rhun
- Department of Medical Oncology and Hematology, University Hospital & University of Zurich, Zurich, Switzerland
| | - Felix Sahm
- Department of Neuropathology, University Hospital Heidelberg and CCU Neuropathology, DKFZ, Heidelberg, Germany
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Jens Gempt
- Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Johan Af Koekkoek
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Angelo F Monti
- Department of Medical Physics, ASST GOM Niguarda, Milano, Italy
| | | | | | - Helen Bulbek
- Brainstrust-the brain cancer people, Isle of Wight, Cowes, UK
| | | | | | | | - Michael Weller
- Department of Neurology, University Hospital & University of Zurich, Zurich, Switzerland
| | - Giuseppe Minniti
- Department of Radiological Sciences, Oncology and Anatomical Pathology and IRCCS Neuromed (IS), Sapienza University, Policlinico Umberto I, Rome, Italy
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Wang Q, Wan C, Li M, Huang Y, Xi X. Mapping the Peds QL TM 4.0 onto CHU-9D: a cross-sectional study in functional dyspepsia population from China. Front Public Health 2023; 11:1166760. [PMID: 37325313 PMCID: PMC10266104 DOI: 10.3389/fpubh.2023.1166760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/30/2023] [Indexed: 06/17/2023] Open
Abstract
Objective The study aims to develop a mapping algorithm from the Pediatric Quality of Life Inventory™ 4. 0 (Peds QL 4.0) onto Child Health Utility 9D (CHU-9D) based on the cross-sectional data of functional dyspepsia (FD) children and adolescents in China. Methods A sample of 2,152 patients with FD completed both the CHU-9D and Peds QL 4.0 instruments. A total of six regression models were used to develop the mapping algorithm, including ordinary least squares regression (OLS), the generalized linear regression model (GLM), MM-estimator model (MM), Tobit regression (Tobit) and Beta regression (Beta) for direct mapping, and multinomial logistic regression (MLOGIT) for response mapping. Peds QL 4.0 total score, Peds QL 4.0 dimension scores, Peds QL 4.0 item scores, gender, and age were used as independent variables according to the Spearman correlation coefficient. The ranking of indicators, including the mean absolute error (MAE), root mean squared error (RMSE), adjusted R2, and consistent correlation coefficient (CCC), was used to assess the predictive ability of the models. Results The Tobit model with selected Peds QL 4.0 item scores, gender and age as the independent variable predicted the most accurate. The best-performing models for other possible combinations of variables were also shown. Conclusion The mapping algorithm helps to transform Peds QL 4.0 data into health utility value. It is valuable for conducting health technology evaluations within clinical studies that have only collected Peds QL 4.0 data.
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Ayala A, Ramallo-Fariña Y, Bilbao-Gonzalez A, Forjaz MJ. Mapping the EQ-5D-5L from the Spanish national health survey functional disability scale through Bayesian networks. Qual Life Res 2023; 32:1785-1794. [PMID: 36735174 DOI: 10.1007/s11136-023-03351-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE Preference-based measures are valuable tools for evaluating therapeutic interventions and for cost-effectiveness studies. Mapping procedures are useful when it is not possible to collect these kind of measures. The objective of this study was to evaluate which mapping method is the most appropriate to estimate the EQ-5D-5L index from the Spanish National Health Survey functional disability scale. METHODS The sample, formed by 5708 older adults (aged 65 years or older), was drawn from the Spanish National Health Survey ("Encuesta Nacional de Salud en España," ENSE in Spanish 2011-2012). The predictions of EQ-5D-5L index were performed with response mapping using Bayesian network (BN), ordered logit (Ologit), and multinomial logistic (ML). The following direct methods were used: ordinary least squares (OLS) and Tobit regression. The intraclass correlation coefficient (ICC), absolute error (MAE), mean squared error (MSE), and root-mean squared error (RMSE) were calculated to compare all models. The predictions of response models were obtained through the expected value method. RESULTS BN model showed the highest ICC (0.756, 95% confidence interval, CI 0.733-0.777) and lowest MAE (0.110, 95% CI 0.104-0.115). OLS was the model with worse accuracy results with lowest ICC (0.621, 95% CI 0.553-0.681) and highest MAE (0.159, 95%CI: 0.145-0.173). CONCLUSION Indirect mapping methods (BN, Ologit, and ML) had a better accuracy than the direct methods. The response mapping approach provides a robust method to estimate EQ-5D-5L scores from the functional disability scale.
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Affiliation(s)
- Alba Ayala
- Department of Statistics, School of Law and Social Sciences, University Carlos III of Madrid, 126-28903, Getafe, Madrid, Spain. .,Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain. .,Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.
| | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Santa Cruz de Tenerife, Tenerife, Spain.,Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain.,Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Amaia Bilbao-Gonzalez
- Osakidetza Basque Health Service, Basurto University Hospital, Research and Innovation Unit, Bilbao, Spain.,Kronikgune Institute for Health Services Research, Barakaldo, Spain.,Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain.,Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain.,Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain.,Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
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Hagiwara Y, Shiroiwa T, Taira N, Kawahara T, Konomura K, Noto S, Fukuda T, Shimozuma K. Gradient Boosted Tree Approaches for Mapping European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 Onto 5-Level Version of EQ-5D Index for Patients With Cancer. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:269-279. [PMID: 36096966 DOI: 10.1016/j.jval.2022.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/10/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to develop direct and response mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 onto the 5-level version of EQ-5D index based on the gradient boosted tree (GBT), a promising modern machine learning method. METHODS We used the Quality of Life Mapping Algorithm for Cancer study data (903 observations from 903 patients) for training GBTs and testing their predictive performance. In the Quality of Life Mapping Algorithm for Cancer study, patients with advanced solid tumor were enrolled, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and 5-level version of EQ-5D were simultaneously evaluated. The Japanese value set was used for direct mapping, whereas the Japanese and US value sets were used for response mapping. We trained the GBTs in the training data set (80%) with cross-validation and tested the predictive performance measured by the root mean squared error (RMSE), mean absolute error (MAE), and mean error in the test data set (20%). RESULTS The RMSE and MAE in the test data set were larger in the GBT approaches than in the previously developed regression-based approaches. The mean error in the test data set tended to be smaller in the GBT approaches than in the previously developed regression-based approaches. CONCLUSIONS The predictive performances in the RMSE and MAE did not improve by the GBT approaches compared with regression approaches. The flexibility of the GBT approaches had the potential to reduce overprediction and underprediction in poor and good health, respectively. Further research is needed to establish the role of machine learning methods in mapping a nonpreference-based measure onto health utility.
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Affiliation(s)
- Yasuhiro Hagiwara
- Department of Biostatistics, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
| | - Naruto Taira
- Department of Breast and Thyroid Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Takuya Kawahara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiko Konomura
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
| | - Shinichi Noto
- Center for Health Economics and QOL Research, Niigata University of Health and Welfare, Niigata, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
| | - Kojiro Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, Kusatsu, Japan
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