Comparison of Mean Overall Survival (OS) and Radiographic Progression Free Survival (RPFS) Based on Matching Adjusted Indirect Comparison of Abiraterone Acetate and Enzalutamide for the Treatment of Castration-Resistant Prostate Cancer in Chemotherapy Naïve Patients

Abstract

cal data for lung metastasis, primary and secondary liver cancer, locally advanced pancreatic cancer population treated with CyberKnife radiation. Searching using Medline, EMBASE, Cochrane Library took place in September 2013. Results: Only one relevant comparative clinical study (matched-pair analysis) met the inclusion criteria, assessing effectiveness and safety of stereotactic radiosurgery and radiofrequency ablation for colorectal liver metastasis. For other neoplasms single-arm studies were found. Compared to RFA CyberKnife for liver metastasis was significantly better in median local disease free survival, which was 34.4 months vs. 6.0 months, (p< 0.001). 1 and 2-year local control rates also favored CK (85.0% vs. 65.0% and 80.0% vs. 61.0%, respectively) but the difference wasn't significant. However, trend for better OS was found with RFA (34.4 vs. 52.3 months). For lung metastasis, treatment with CK resulted in 24.0-62.0% complete or partial response, 38.0-76.0% patients stabilized. In primary liver tumors OR (CR + PR) was observed in 63.0-86.0% patients, 0.0-29.0% stabilized, median PFS reached 10.0-15.8 months. Inconsistent results were seen in locally advanced pancreatic cancer population. In one study 92.0% responded or stabilized but in other only 1 patient of 77 had PR. Median OS was 6.4-10.3 months. All studies reported mostly mild adverse events after CK. Serious AE were rare. ConClusions: There is limited quality evidence on the effectiveness and safety of robotic image-guided stereotactic radiosurgery in patients with soft tissue neoplasms. Available studies are highly heterogenic in methods, patients characteristics and outcomes but suggest that CyberKnife may be beneficial in local tumor control. There is a need of well-designed comparative studies.

Secukinumab Versus Adalimumab for Psoriatic Arthritis: Comparative Effectiveness up to 48 Weeks Using a Matching-Adjusted Indirect Comparison

“…In these situations, the use of MAIC may be the only way to adjust for cross-trial differences and should be preferred over naïve unadjusted comparisons. Commonly used in observational studies [36], this approach has been successfully applied to previous MAIC analyses of RCTs, such as when placebo comparisons were not available or valid [37], to overcome placebo crossover, or extrapolation beyond study end [32,38]. A week 12, placebo-adjusted comparison was also made.…”

“…When populations are well matched [8], it is possible to compare long-term data beyond the placebo-controlled phase. This is necessary for chronic conditions such as PsA because the short-term placebo-controlled phase of most RCTs provides only limited data to inform the mid-to long-term treatment choices; indeed, several oncology studies have applied MAIC successfully to long-term patient survival data [37,38].…”

Indirect treatment comparison of cabazitaxel for patients with metastatic castrate-resistant prostate cancer who have been previously treated with a docetaxel-containing regimen

“…It appears that this study included an interim report [ 20 ] and a final report [ 14 ] from the COU-AA-301 trial for abiraterone in their indirect treatment comparisons which may have skewed their results. One study [ 17 ] compared mean survival for the two groups and found that the mean survival for enzalutamide (38.7 months; 95% CI = 36.4–40.7) was greater than the mean survival for abiraterone (34.6 months; 95% CI = 31.8–37.8). However, the mean survival time is not informative for understanding the efficacy of a drug on survival as all of the deaths in the study population would have to be observed before a valid mean survival time could be calculated.…”

“…However, the mean survival time is not informative for understanding the efficacy of a drug on survival as all of the deaths in the study population would have to be observed before a valid mean survival time could be calculated. Indirect estimates of median radiographic PFS for abiraterone and enzalutamide were similar (both calculated an indirect HR = 0.61; 95% CI = 0.50–0.74) in two studies [ 18 , 19 ] while a third study compared means of radiographic PFS [ 17 ]. We did not include enzalutamide in our indirect treatment comparison analysis of PFS as the AFFIRM trial introduced heterogeneity into the model.…”

Comparative effectiveness of secukinumab and adalimumab in ankylosing spondylitis as assessed by matching-adjusted indirect comparison

“…Therefore, after week 12, outcomes from the adalimumab arm of ATLAS were directly compared with outcomes from the adjusted and recalculated pooled secukinumab 150 mg arms of MEASURE 1/2. This unanchored (non-placebo-adjusted) MAIC methodology is recommended by NICE in cases when anchored comparisons are not possible ( 14 , 17 , 22 – 24 ).…”