Matching‐adjusted indirect comparison of isatuximab plus carfilzomib and dexamethasone with daratumumab plus lenalidomide and dexamethasone in relapsed multiple myeloma

Abstract

Lenalidomide-based regimens are commonly used for early relapse in patients with relapsed and/or refractory multiple myeloma (RRMM) receiving at least one prior line of therapy. In the absence of headto-head comparison, matching-adjusted indirect comparison (MAIC) was conducted to demonstrate e cacy and safety of isatuximab+car lzomib+dexamethasone (Isa-Kd) vs. daratumumab+lenalidomide+dexamethasone (Dara-Rd) in RRMM. Patient-level data from IKEMA trial (Isa-Kd, n=179) were matched to aggregate data from POLLUX (Dara-Rd, n=286). Hazard ratios (HR) and 95% con dence intervals (CI) for progression-free survival (PFS) and overall survival (OS) were generated by weighted Cox proportional hazard models. Odds ratios (OR), 95% CI, and p-value were calculated for ≥very good partial response (≥VGPR) and treatment-emergent adverse events (TEAEs). After matching, no signi cant differences were observed between Isa-Kd and Dara-Rd in baseline characteristics except for patients with >3 prior lines (0.0% vs. 4.9%). Isa-Kd showed signi cantly better PFS (HR [95% CI]: 0.46 [0.24-0.86]; p=0.0155), statistically non-signi cant improvement favoring Isa-Kd in OS (0.47 [0.20-1.09]; 0.0798), and ≥VGPR (OR [95% CI]: 1.53 [0.89-2.64]; p=0.1252) than Dara-Rd. Odds of occurrence were signi cantly lower for some all-grade and grade 3/4 TEAEs with Isa-Kd than Dara-Rd. These results support Isa-Kd as an e cacious treatment for early relapse in non-lenalidomide refractory patients.

Cost-effectiveness of edaravone dexborneol versus dl-3-n-butylphthalide for the treatment of acute ischemic stroke: a Chinese health care perspective

“…The absence of head-to-head trial for ED versus NBP is a challenge for this study. Matching-adjusted indirect comparison (MAIC) analyses have been reported as a new tool for timely comparative effectiveness research [ 11 ], and have previously been conducted for effectiveness comparison and cost analysis between different therapies [ 11 – 16 ]. This study applied unanchored MAIC to compare the effectiveness of ED versus NBP, based on the individual patient data (IPD) of the TASTE trial (ED) and aggregated data of the NBP trial below.…”

Matching-Adjusted Indirect Comparisons Applied for Comparative Efficacy of Haematologic Cancer Drugs within Health Economic Analysis

“…A Google search including all hits has returned 40 unique manuscripts and conference proceedings that were published between 2011 -February 2022 (excluding the three MAICs conducted and published for the purpose of this thesis), with half of them being published from 2020 onwards [71,73,. Of these, three were anchored MAICs [71,75,80], 16 were unanchored MAICs [78,79,84,85,90,91,[94][95][96][97]102,[107][108][109][110]112], and for 21 anchoring was not specified [73,76,77,[81][82][83][86][87][88][89]92,93,[98][99][100][101][103][104][105][106]111].…”

“…Most of the published MAICs were in relapsed/refractory [105][106][107][108][109][110][111][112] multiple myeloma [84][85][86][87][88][89][90][91], followed by chronic myeloid leukaemia [73,[80][81][82][83], relapsed/refractory diffuse large Bcell lymphoma [93][94][95][96][97][98], and relapsed/refractory follicular lymphoma [99][100][101][102]. The fewest MAICs were published in relapsed/refractory acute lymphoblastic leukaemia [71], and relapsed/refractory classical Hodgkin lymphoma [92], with one publication for each.…”

“…A clear differentiation between effect modifiers and prognostic factors was made in only three publications [97,102,106] of the 16 MAICs explicitly identified as "unanchored". Effect modifiers/prognostic factors have been listed without a justification of their source in 14 cases [73,75,80,82,84,87,88,91,93,94,100,103,106,111]. Expert/clinician opinion was obtained in seven cases [78,95,97,101,102,104,105].…”

“…Only two studies have reported on the weights distribution [77,78], while 16 studies have reported on the effective sample size [76][77][78]81,85,92,94,[95][96][97]101,[103][104][105]107,108]. Time-to-event endpoints have been assessed in 33 [71,73,[76][77][78][79][80][81][83][84][85][86][87][88][89][90][92][93][94][95][96][97][98]102,103,[105][106][107][108][109][110][111]…”