First-line bevacizumab-based therapy versus pemetrexed + cisplatin for the treatment of advance adenocarcinoma non squamous non-small cell lung cancer: indirect comparison applying real-life outcomes.

First-line bevacizumab-based therapy versus pemetrexed + cisplatin for the treatment of advance adenocarcinoma non squamous non-small cell lung cancer: indirect comparison applying real-life outcomes.

2010 Value in health

Berenson, K. | Chouaid, C. | Vergnenegre, A. | Sherman, S. | Walzer, S. | Volume: 13, Issue: 7, Pages: , therapy, Cisplatin,

OBJECTIVES: In the absence of head-to-head clinical trial data, an indirect comparison
of bevacizumab (BEV) versus pemetrexed (PMX) was conducted to compare
survival outcomes among adenocarcinoma nonsquamous metastatic Non-Small Cell
Lung Cancer (mNSCLC) patients. METHODS: An adjusted matched indirect analysis
was conducted to estimate overall survival (OS) in adenocarcinoma mNSCLC patients
treated with BEV + cisplatin doublet therapy using patient-level data from SAiL
(ECCO/ESMO 2009). These estimates were indirectly compared to previously published
survival outcomes for PMX + cisplatin-treated patients (Oncologist
2009;14:253–263) by calculating the median ratio (MR) for OS. a subset of the SAiL
population was selected to more closely approximate the PMX population by excluding
patients who did not have cisplatin doublet as their baseline treatment, those with
a baseline Eastern Cooperative Oncology Group (ECOG) performance status (PS) of
> = 2, and those with non-adenocarcinoma histology. This sample of BEV patients
was matched to the adenocarcinoma subgroup from the PMX trial on stage of disease
and ECOG PS. One thousand repeated random matched samples of the SAiL data
were produced to generate a distribution of survival outcomes and infer a 95% confi
dence interval (CI) around the mean of all sampled median survival estimates.
RESULTS: After adjusted matching, the estimated median OS benefi t for BEV patients
was 15.6 months (95% CI: 15.0, 16.5) compared to the published median OS of 12.6
months (95% CI: 10.7, 13.6) for PMX patients. BEV patients had longer median OS
with an MR of 0.81 (95% CI: 0.71, 0.82). CONCLUSIONS: Results from this indirect
comparison show that BEV-based therapy provides superior overall survival outcomes
when compared to PMX in adenocarcinoma mNSCLC patients.