Network meta-analysis of pembrolizumab as monotherapy and in combination with chemotherapy for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma.
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| Title: | Network meta-analysis of pembrolizumab as monotherapy and in combination with chemotherapy for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma. |
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| Alternate Title: | Metanálise em rede comparativa de pembrolizumabe como monoterapia e em combinação com quimioterapia para tratamento de primeira linha de carcinoma de células escamosas da cabeça e pescoço recorrente ou metastático. |
| Authors: | Mojebi, Ali1, Ramakrishnan, Karthik2 karthik.ramakrishnan1@merck.com, Ayers, Dieter1, Keeping, Sam1, Borse, Rebekah2, Chirovsky, Diana2 |
| Source: | JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde. abr2024, Vol. 16 Issue 1, p25-64. 40p. |
| Subjects: | SQUAMOUS cell carcinoma, COMBINATION drug therapy, PEMBROLIZUMAB, BAYESIAN analysis, OVERALL survival |
| Abstract (English): | Pembrolizumab monotherapy or in combination with chemotherapy is approved as first-line treatment in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) based on improved overall survival (OS) versus EXTREME regimen in the KEYNOTE-048 trial. The clinical outcomes of pembrolizumab were compared with other recommended first-line treatments in R/M HNSCC in this study through a Bayesian network meta-analysis. A systematic literature review was conducted in July 2022, from which six trials that matched the KEYNOTE-048 patient eligibility criteria were included in the network. The OS and progression-free survival (PFS) outcomes were compared in the approved pembrolizumab indication (i.e., total population for pembrolizumab in combination with chemotherapy and combined positive score [CPS] ≥ 1 population for pembrolizumab monotherapy). A significant OS improvement was observed for pembrolizumab in combination with chemotherapy and pembrolizumab monotherapy versus EXTREME regimen (hazard ratio, 95% credible interval: 0.72, 0.60-0.86; 0.73, 0.60-0.88), platinum+5- FU (0.58, 0.43-0.76; 0.58, 0.44-0.78), and platinum+paclitaxel (0.53, 0.35-0.79; 0.53, 0.35-0.81), respectively. A non-significant numeric trend in OS improvement was observed versus the TPEx regimen. PFS was comparable with most first-line treatments and was improved versus platinum+5-FU (0.48, 0.36-0.64; 0.59, 0.45-0.79). Additional analyses in higher CPS subgroups also showed consistent results. Overall, our study results showed an improvement in OS outcomes versus alternative first-line treatments, consistent with the findings of the KEYNOTE-048 trial. These data support using pembrolizumab as a suitable firstline treatment option in R/M HNSCC. [ABSTRACT FROM AUTHOR] |
| Abstract (Portuguese): | Pembrolizumabe em monoterapia ou em combinação com quimioterapia é aprovado como tratamento de primeira linha em carcinoma de células escamosas recorrente/metastático de cabeça e pescoço (CECCP R/M) com base na melhora da sobrevida global (OS), em comparação com o esquema EXTREME no estudo KEYNOTE-048. Esse estudo comparou os resultados clínicos de pembrolizumabe com outros tratamentos recomendados de primeira linha em CECCP R/M por meio de uma metanálise de rede bayesiana. Uma revisão sistemática da literatura foi conduzida em julho de 2022, a partir da qual seis ensaios clínicos que atendiam aos critérios de elegibilidade de pacientes do KEYNOTE-048 foram incluídos na rede. Os desfechos de OS e sobrevida livre de progressão (PFS) foram comparados na indicação de pembrolizumabe (população total para pembrolizumabe em combinação com quimioterapia e população com escore positivo combinado [CPS] ≥ 1 em monoterapia com pembrolizumabe). Foi observada melhora significativa na OS para pembrolizumabe em combinação com quimioterapia e monoterapia com pembrolizumabe versus o esquema EXTREME (razão de risco, intervalo de confiança de 95%: 0,72, 0,60-0,86; 0,73, 0,60-0,88), platina+5-FU (0,58, 0,43-0,76; 0,58, 0,44-0,78) e platina+paclitaxel (0,53, 0,35-0,79; 0,53, 0,35-0,81), respectivamente. Uma tendência numérica não significativa de melhoria na OS foi observada em relação ao esquema TPEx. A PFS foi comparável com a maioria dos tratamentos de primeira linha e melhor em relação à platina+5-FU (0,48, 0,36-0,64; 0,59, 0,45-0,79). Análises adicionais em subgrupos com CPS mais elevado também mostraram resultados consistentes. No geral, os resultados de nosso estudo mostraram melhora nos desfechos de OS em comparação aos tratamentos de primeira linha alternativos, consistentes com os achados do estudo KEYNOTE-048. Esses dados apoiam o uso de pembrolizumabe como opção de tratamento em primeira linha em pacientes com CECCP R/M. [ABSTRACT FROM AUTHOR] |
| Copyright of JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde is the property of JBES: Brazilian Journal of Health Economics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
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| Header | DbId: lth DbLabel: MedicLatina An: 178141887 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Network meta-analysis of pembrolizumab as monotherapy and in combination with chemotherapy for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Metanálise em rede comparativa de pembrolizumabe como monoterapia e em combinação com quimioterapia para tratamento de primeira linha de carcinoma de células escamosas da cabeça e pescoço recorrente ou metastático. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Mojebi%2C+Ali%22">Mojebi, Ali</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Ramakrishnan%2C+Karthik%22">Ramakrishnan, Karthik</searchLink><relatesTo>2</relatesTo><i> karthik.ramakrishnan1@merck.com</i><br /><searchLink fieldCode="AR" term="%22Ayers%2C+Dieter%22">Ayers, Dieter</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Keeping%2C+Sam%22">Keeping, Sam</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Borse%2C+Rebekah%22">Borse, Rebekah</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Chirovsky%2C+Diana%22">Chirovsky, Diana</searchLink><relatesTo>2</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22JBES%3A+Brazilian+Journal+of+Health+Economics+%2F+Jornal+Brasileiro+de+Economia+da+Saúde%22">JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde</searchLink>. abr2024, Vol. 16 Issue 1, p25-64. 40p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22SQUAMOUS+cell+carcinoma%22">SQUAMOUS cell carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22COMBINATION+drug+therapy%22">COMBINATION drug therapy</searchLink><br /><searchLink fieldCode="DE" term="%22PEMBROLIZUMAB%22">PEMBROLIZUMAB</searchLink><br /><searchLink fieldCode="DE" term="%22BAYESIAN+analysis%22">BAYESIAN analysis</searchLink><br /><searchLink fieldCode="DE" term="%22OVERALL+survival%22">OVERALL survival</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Pembrolizumab monotherapy or in combination with chemotherapy is approved as first-line treatment in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) based on improved overall survival (OS) versus EXTREME regimen in the KEYNOTE-048 trial. The clinical outcomes of pembrolizumab were compared with other recommended first-line treatments in R/M HNSCC in this study through a Bayesian network meta-analysis. A systematic literature review was conducted in July 2022, from which six trials that matched the KEYNOTE-048 patient eligibility criteria were included in the network. The OS and progression-free survival (PFS) outcomes were compared in the approved pembrolizumab indication (i.e., total population for pembrolizumab in combination with chemotherapy and combined positive score [CPS] ≥ 1 population for pembrolizumab monotherapy). A significant OS improvement was observed for pembrolizumab in combination with chemotherapy and pembrolizumab monotherapy versus EXTREME regimen (hazard ratio, 95% credible interval: 0.72, 0.60-0.86; 0.73, 0.60-0.88), platinum+5- FU (0.58, 0.43-0.76; 0.58, 0.44-0.78), and platinum+paclitaxel (0.53, 0.35-0.79; 0.53, 0.35-0.81), respectively. A non-significant numeric trend in OS improvement was observed versus the TPEx regimen. PFS was comparable with most first-line treatments and was improved versus platinum+5-FU (0.48, 0.36-0.64; 0.59, 0.45-0.79). Additional analyses in higher CPS subgroups also showed consistent results. Overall, our study results showed an improvement in OS outcomes versus alternative first-line treatments, consistent with the findings of the KEYNOTE-048 trial. These data support using pembrolizumab as a suitable firstline treatment option in R/M HNSCC. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Portuguese) Group: Ab Data: Pembrolizumabe em monoterapia ou em combinação com quimioterapia é aprovado como tratamento de primeira linha em carcinoma de células escamosas recorrente/metastático de cabeça e pescoço (CECCP R/M) com base na melhora da sobrevida global (OS), em comparação com o esquema EXTREME no estudo KEYNOTE-048. Esse estudo comparou os resultados clínicos de pembrolizumabe com outros tratamentos recomendados de primeira linha em CECCP R/M por meio de uma metanálise de rede bayesiana. Uma revisão sistemática da literatura foi conduzida em julho de 2022, a partir da qual seis ensaios clínicos que atendiam aos critérios de elegibilidade de pacientes do KEYNOTE-048 foram incluídos na rede. Os desfechos de OS e sobrevida livre de progressão (PFS) foram comparados na indicação de pembrolizumabe (população total para pembrolizumabe em combinação com quimioterapia e população com escore positivo combinado [CPS] ≥ 1 em monoterapia com pembrolizumabe). Foi observada melhora significativa na OS para pembrolizumabe em combinação com quimioterapia e monoterapia com pembrolizumabe versus o esquema EXTREME (razão de risco, intervalo de confiança de 95%: 0,72, 0,60-0,86; 0,73, 0,60-0,88), platina+5-FU (0,58, 0,43-0,76; 0,58, 0,44-0,78) e platina+paclitaxel (0,53, 0,35-0,79; 0,53, 0,35-0,81), respectivamente. Uma tendência numérica não significativa de melhoria na OS foi observada em relação ao esquema TPEx. A PFS foi comparável com a maioria dos tratamentos de primeira linha e melhor em relação à platina+5-FU (0,48, 0,36-0,64; 0,59, 0,45-0,79). Análises adicionais em subgrupos com CPS mais elevado também mostraram resultados consistentes. No geral, os resultados de nosso estudo mostraram melhora nos desfechos de OS em comparação aos tratamentos de primeira linha alternativos, consistentes com os achados do estudo KEYNOTE-048. Esses dados apoiam o uso de pembrolizumabe como opção de tratamento em primeira linha em pacientes com CECCP R/M. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde is the property of JBES: Brazilian Journal of Health Economics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.21115/JBES.v16.n1.p25-64 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 40 StartPage: 25 Subjects: – SubjectFull: SQUAMOUS cell carcinoma Type: general – SubjectFull: COMBINATION drug therapy Type: general – SubjectFull: PEMBROLIZUMAB Type: general – SubjectFull: BAYESIAN analysis Type: general – SubjectFull: OVERALL survival Type: general Titles: – TitleFull: Network meta-analysis of pembrolizumab as monotherapy and in combination with chemotherapy for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Mojebi, Ali – PersonEntity: Name: NameFull: Ramakrishnan, Karthik – PersonEntity: Name: NameFull: Ayers, Dieter – PersonEntity: Name: NameFull: Keeping, Sam – PersonEntity: Name: NameFull: Borse, Rebekah – PersonEntity: Name: NameFull: Chirovsky, Diana IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: abr2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 21752095 Numbering: – Type: volume Value: 16 – Type: issue Value: 1 Titles: – TitleFull: JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde Type: main |
| ResultId | 1 |
