Overall survival indirect treatment comparison between brigatinib and alectinib for the treatment of front-line anaplastic lymphoma kinase-positive non-small cell lung cancer using data from ALEX and final results from ALTA-1L.
Date
2022-07-28ICR Author
Author
Reckamp, KL
Lin, HM
Cranmer, H
Wu, Y
Zhang, P
Kay, S
Walton, LJ
Shen, J
Popat, S
Camidge, DR
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: Second-generation anaplastic lymphoma kinase (ALK) gene targeted tyrosine kinase inhibitors (TKIs) alectinib and brigatinib have shown efficacy as front-line treatments for ALK-positive non-small cell lung cancer (NSCLC). No head-to-head data are currently available for brigatinib vs alectinib in the ALK-TKI-naive population. OBJECTIVE: To estimate the relative overall survival (OS) for brigatinib vs alectinib with indirect treatment comparisons (ITCs) using ALEX and ALTA-1L clinical trial data. METHODS: The latest aggregate data from the ALEX trial and final patient-level data from ALTA-1L were used. ITCs were conducted with/without treatment crossover adjustments to estimate relative OS. Bucher methods, anchored matching-adjusted indirect comparisons (MAICs) and unanchored MAICs were employed in ITCs without treatment crossover adjustments. An inverse probability of censoring weight Cox model, a marginal structure model and rank-preserving structural failure time models (with/without re-censoring) within an anchored MAIC were used in ITCs with treatment crossover adjustments. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported. RESULTS: HRs for brigatinib vs alectinib for relative OS generated from ITCs without treatment crossover adjustments ranged from 0.90 (95% CI: 0.59-1.38) in the unanchored MAIC to 1.20 (95% CI: 0.69-2.11) using the Bucher method. Methods employing treatment switching adjustments estimated HRs for relative OS ranging from 0.74 (95% CI: 0.38-1.45) to 1.11 (95% CI: 0.63-1.94). Results from all ITCs did not indicate statistically different survival profiles. CONCLUSION: Regardless of ITC methodology, OS is comparable for brigatinib vs alectinib in patients with ALK+ NSCLC previously untreated with an ALK inhibitor.
Collections
Subject
ALK+ NSCLC
alectinib
brigatinib
indirect treatment comparison
overall survival
Anaplastic Lymphoma Kinase
Carbazoles
Carcinoma, Non-Small-Cell Lung
Crizotinib
Humans
Lung Neoplasms
Organophosphorus Compounds
Piperidines
Protein Kinase Inhibitors
Pyrimidines
Language
eng
Date accepted
2022-07-08
License start date
2022-07-28
Citation
Current Medical Research and Opinion, 2022, 38 (9), pp. 1587 - 1593
Publisher
TAYLOR & FRANCIS LTD