Matching-adjusted indirect treatment comparison of [(177)Lu]Lu-DOTA-TATE, everolimus and sunitinib in advanced, unresectable gastroenteropancreatic neuroendocrine tumours: Relative effectiveness of [(177)Lu]Lu-DOTA-TATE in gastroenteropancreatic neuroendocrine tumours

Head-to-head comparisons of the efficacy of treatments for gastroenteropancreatic neuroendocrine tumours (GEP-NETs) have not yet been reported. This study used a series of matching-adjusted indirect comparisons to indirectly compare the effectiveness of [(177)Lu]Lu-DOTA-TATE to everolimus, sunitinib...

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Detalles Bibliográficos
Autores principales: Khan, Mohid S., Stamp, Elaine, Sammon, Cormac, Brabander, Tessa, de Herder, Wouter W., Pavel, Marianne E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591206/
https://www.ncbi.nlm.nih.gov/pubmed/34912478
http://dx.doi.org/10.1016/j.ejcsup.2021.06.002
Descripción
Sumario:Head-to-head comparisons of the efficacy of treatments for gastroenteropancreatic neuroendocrine tumours (GEP-NETs) have not yet been reported. This study used a series of matching-adjusted indirect comparisons to indirectly compare the effectiveness of [(177)Lu]Lu-DOTA-TATE to everolimus, sunitinib and best supportive care (BSC) for extending progression-free survival and overall survival in patients with advanced, unresectable gastrointestinal (GI)-NETs and P-NETs. The results of the main analysis suggest that after accounting for differences in key prognostic variables, the hazard of progression was 62% (hazard ratio [HR], 0.38; confidence interval [CI](95) 0.25–0.58) and 65% (HR 0.35 CI(95) 0.21–0.59) lower in patients with GI-NETs treated with [(177)Lu]Lu-DOTA-TATE than in those treated with everolimus and BSC, respectively. Similarly, the hazard of progression was 64% (HR 0.36 CI(95) 0.18–0.70), 54% (HR 0.46 CI(95) 0.30–0.71) and 79–87% (HR 0.21 CI(95) 0.13–0.32; HR 0.13 CI(95) 0.08–0.22) lower in patients with P-NET treated with [(177)Lu]Lu-DOTA-TATE than in those treated with sunitinib, everolimus and BSC, respectively. The hazard of death was 58% (HR 0.42 CI(95) 0.25–0.72), 47% (HR 0.53 CI(95) 0.33–0.87) and 44–64% (HR 0.56 CI(95) 0.36–0.90; HR 0.34 CI(95) 0.20–0.57) lower in P-patients with NET treated with [(177)Lu]Lu-DOTA-TATE than in those treated with sunitinib, everolimus and BSC, respectively. While our results must be interpreted with caution given the non-randomised nature of the comparisons and the potential for residual confounding, the magnitude of the effect sizes we observe and their consistency across comparators suggest that [(177)Lu]Lu-DOTA-TATE may be a more effective treatment option than everolimus, sunitinib and BSC in advanced, unresectable GEP-NETs.

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