在一线转移性割抗性前列腺癌的历史试验中,从代孕终点预测治疗效果
Imtiaz A Samjoo1, Tim Disher1, Elena Castro2
1EVERSANA™, Burlington, Ontario, Canada.
Clinical genitourinary cancer
|July 11, 2024
概括
代孕模型预测了转移性割抵抗性前列腺癌治疗的缺失生存数据. 多塞塔克塞尔在无放射性进展生存率和整体生存率方面显示出最有可能成为最有效的治疗方法.
科学领域:
- 卫生技术评估 卫生技术评估
- 药物经济学 药物经济学
- 在瘤学瘤学.
背景情况:
- 医疗技术评估中的成本效益模型 (CEM) 依赖于可靠的输入参数.
- 替代终点在评估癌症治疗时变得越来越重要,因为最终的生存数据有限.
- 由于复杂的疗效数据,转移性抵抗割的前列腺癌 (mCRPC) 在治疗选择方面存在挑战.
研究的目的:
- 在第一线mCRPC治疗中预测无放射性进展生存期 (rPFS) 和总生存期 (OS) 的缺失效应估计.
- 用网络元分析 (NMA) 来评估mCRPC治疗的比较疗效,其中包括预测数据.
- 通过生成以前无法获得的治疗效果数据,为复杂的成本效益模型提供信息.
主要方法:
- 利用丹尼尔斯和休斯替代模型来预测未报告的RPFS或OS效应估计.
- 进行贝叶斯网络元分析 (NMA),整合观察和预测的治疗效果.
- 搜索了多个数据库和灰色文献,查找相关的随机对照试验 (RCT) 到2022年10月.
主要成果:
- 包括25个RCT;rPFS预测为12个RCT和10个比较器;OS预测为5个RCT和6个比较器.
- 非标准的多塞塔塞尔剂量 (50毫克/米2每2周一次) 显示出对rPFS (p-best:59%) 和OS (p-best:48%) 两种疗法最有效的可能性最高.
- 塔拉佐巴里布加恩扎胺在RPFS (13%) 和OS (19%) 中的疗效概率是第二高的.
结论:
- 先进的代孕模型成功生成了基本参数和间接治疗效果估计.
- 这种方法提供了一个可行的方法来填充成本效益模型,先前没有可用的rPFS和OS数据用于第一线mCRPC.
- 这些发现突出了一个特定的多塞塔克塞尔疗法,可能是基于预测的生存结果,对mCRPC最有效的第一线治疗.
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