A Matching-adjusted Indirect Comparison of Nivolumab Plus Cabozantinib Versus Pembrolizumab Plus Axitinib in Patients with Advanced Renal Cell Carcinoma

被引：6

作者：

McGregor, Bradley ^{[1
]}

Geynisman, Daniel M. ^{[2
]}

Burotto, Mauricio ^{[3
]}

Suarez, Cristina ^{[4
]}

Bourlon, Maria T. ^{[5
]}

Barata, Pedro C. ^{[6
]}

Gulati, Shuchi ^{[7
,19
]}

Huo, Stephen ^{[8
]}

Ejzykowicz, Flavia ^{[8
]}

Blum, Steven I. ^{[8
]}

Del Tejo, Viviana ^{[9
]}

Hamilton, Melissa ^{[8
]}

May, Jessica R. ^{[10
]}

Du, Ella X. ^{[11
]}

Wu, Aozhou ^{[11
]}

Kral, Pavol ^{[12
]}

Ivanescu, Cristina ^{[13
]}

Chin, Andi ^{[11
]}

Betts, Keith A. ^{[11
]}

Lee, Chung-Han ^{[14
]}

Choueiri, Toni K. ^{[1
,15
,16
]}

Cella, David ^{[17
,21
,22
]}

Porta, Camillo ^{[18
,20
]}

机构：

[1] Dana Farber Canc Inst, Lank Ctr Genitourinary Oncol, Boston, MA USA

[2] Fox Chase Canc Ctr, Dept Hematol & Oncol, Philadelphia, PA USA

[3] Bradford Hill Clin Res Ctr, Santiago, Chile

[4] Hosp Univ Vall dHebron, Vall dHebron Inst Oncol VHIO, Med Oncol Dept, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain

[5] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Hematol Oncol Dept, Mexico City, Mexico

[6] Tulane Univ, Deming Dept Med, Sch Med, New Orleans, LA USA

[7] Univ Cincinnati, Dept Med, Div Hematol & Oncol, Canc Ctr, Cincinnati, OH USA

[8] Bristol Myers Squibb, Worldwide Hlth Econ & Outcomes Res US Market, Princeton, NJ USA

[9] US Med Oncol, Bristol Myers Squibb, Princeton, NJ USA

[10] Bristol Myers Squibb, Worldwide Hlth Econ & Outcomes Res Markets, Uxbridge, England

[11] Anal Grp Inc, Los Angeles, CA USA

[12] IQVIA, Patient Ctr Solut, Bratislava, Slovakia

[13] IQVIA, Patient Ctr Solut, Amsterdam, Netherlands

[14] Mem Sloan Kettering Canc Ctr, Dept Med, New York, NY USA

[15] Brigham & Womens Hosp, Boston, MA USA

[16] Harvard Med Sch, Boston, MA USA

[17] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Dept Med Social Sci, Chicago, IL USA

[18] Univ Bari A Moro, Interdisciplinary Dept Med, Bari, Italy

[19] Univ Calif Davis, Ctr Comprehens Canc, Dept Internal Med, Div Hematol Oncol, Sacramento, CA USA

[20] Univ Bari A Moro, Policlin Consorziale Bari, Piazza G Cesare 11, I-70124 Bari, Italy

[21] Northwestern Univ, Dept Med Social Sci, 625 N Michigan Ave,Suite 2100, Chicago, IL 60208 USA

[22] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, 625 N Michigan Ave,Suite 2100, Chicago, IL 60208 USA

来源：

EUROPEAN UROLOGY ONCOLOGY | 2023年 / 6卷 / 03期

关键词：

Matching-adjusted indirect comparison; Nivolumab; Cabozantinib; Pembrolizumab; Axitinib; Advanced renal cell carcinoma; Progression-free survival; Overall survival; Health-related quality of life; QUALITY-OF-LIFE; OPEN-LABEL; SUNITINIB; DIAGNOSIS; THERAPY; EUROQOL;

D O I：

10.1016/j.euo.2023.01.012

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The comparative efficacy and health-related quality of life (HRQoL) outcomes of nivolumab plus cabozantinib versus pembrolizumab plus axitinib as first-line treatments for advanced renal cell carcinoma (aRCC) have not been assessed in head-to-head trials.Objective: To assess the efficacy and HRQoL outcomes of nivolumab plus cabozantinib versus pembrolizumab plus axitinib.Design, setting, and participants: Patient-level data for nivolumab plus cabozantinib from the CheckMate 9ER trial and published data for pembrolizumab plus axitinib from the KEYNOTE-426 trial were used. CheckMate 9ER data were reweighted to match the key baseline characteristics as reported in KEYNOTE-426.Intervention: Nivolumab (240 mg every 2 wk) plus cabozantinib (40 mg once daily) and pembrolizumab (200 mg every 3 wk) plus axitinib (5 mg twice daily, initially).Outcome measurements and statistical analysis: Hazard ratios (HRs) for progression-free survival (PFS), duration of response, overall survival (OS), and deterioration in HRQoL were assessed using weighted Cox proportional-hazard models, with sunitinib as a common anchor. Objective response rates (ORRs) and changes in HRQoL scores from baseline were assessed as difference-in-differences for the two treatments relative to sunitinib.Results and limitations: After balancing patient characteristics between the trials, nivolumab plus cabozantinib was associated with significantly improved PFS (HR [95% confidence interval {CI}] 0.70 [0.53-0.93]; p = 0.01) and a significantly decreased risk of confirmed deterioration in HRQoL (Functional Assessment of Cancer Therapy-Kidney Symptom Index-Disease-related Symptoms: HR [95% CI] 0.48 [0.34-0.69]) versus pembrolizumab plus axitinib. OS was similar between treatments (HR [95% CI] 0.99 [0.67- 1.44]; p = 0.94). Nivolumab plus cabozantinib was associated with numerically greater ORRs (difference-in-difference [95% CI] 8.4% [-1.7 to 18.4]; p = 0.10) and longer duration of response (HR [95% CI] 0.79 [0.47-1.31]; p = 0.36) than pembrolizumab plus axitinib. Comparative studies using data with a longer duration of follow-up are warranted.Conclusions: Nivolumab plus cabozantinib significantly improved PFS and HRQoL compared with pembrolizumab plus axitinib as first-line treatment for aRCC.

引用

页码：339 / 348

页数：10

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