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Comparative Efficacy of Treatments for Previously Treated Advanced or Metastatic Non-Small-Cell Lung Cancer: A

Junlong Li1, Medha Sasane2, Jing Zhao3

  • 1Analysis Group Inc., 111 Huntington Ave, Floor 14, Boston, MA, 02199, USA. junlong.li@analysisgroup.com.

Advances in Therapy
|June 28, 2018
PubMed
Abstract

Insights

The combination targeted therapy dabrafenib plus trametinib, along with immunotherapy agents pembrolizumab and nivolumab, demonstrated superior efficacy compared to chemotherapy for advanced non-small-cell lung cancer (NSCLC) patients in a network meta-analysis.

Area of Science:

  • Oncology
  • Medical Research
  • Pharmacology

Background:

  • Advanced or metastatic non-small-cell lung cancer (NSCLC) presents treatment challenges, particularly in the second-line setting.
  • The BRAF V600E mutation is rare, precluding randomized trials comparing targeted therapy dabrafenib plus trametinib with other second-line options.
  • A comprehensive assessment of comparative treatment efficacy is crucial for optimizing patient outcomes in previously treated advanced NSCLC.

Purpose of the Study:

  • To conduct a network meta-analysis (NMA) to compare the efficacy of various second-line treatments for advanced or metastatic NSCLC.
  • To evaluate treatments including dabrafenib plus trametinib, chemotherapy agents, immunotherapy, and best supportive care.
  • To assess overall response rates (ORR), disease control rates (DCR), progression-free survival (PFS), and overall survival (OS).

Main Methods:

  • A systematic literature review identified randomized trials for second-line or later treatments in advanced/metastatic NSCLC.
  • Network meta-analysis (NMA) was performed using logit models for ORR/DCR and fractional polynomial hazards models for PFS/OS.
  • Dabrafenib plus trametinib was indirectly compared to nivolumab via matching-adjusted indirect comparison.

Main Results:

  • Dabrafenib plus trametinib, pembrolizumab, and nivolumab showed significantly higher odds of achieving overall response compared to docetaxel.
  • Higher disease control rates were observed for dabrafenib plus trametinib, nintedanib plus docetaxel, and pemetrexed.
  • Patients receiving dabrafenib plus trametinib, nivolumab, or pembrolizumab experienced significantly lower hazards of disease progression and death at 6 months and 1 year, respectively, compared to docetaxel.

Conclusions:

  • In previously treated advanced or metastatic NSCLC, dabrafenib plus trametinib, pembrolizumab, and nivolumab are associated with improved efficacy.
  • These agents demonstrate higher overall response rates and prolonged progression-free and overall survival compared to chemotherapy.
  • The findings support the consideration of these targeted and immunotherapy options in the second-line treatment landscape for advanced NSCLC.
Keywords:
Comparative efficacyDabrafenibNetwork meta-analysisNon-small-cell lung cancerTrametinib

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