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Article: Comparative Efficacy of Cabozantinib and Regorafenib for Advanced Hepatocellular Carcinoma

TitleComparative Efficacy of Cabozantinib and Regorafenib for Advanced Hepatocellular Carcinoma
Authors
KeywordsCabozantinib
CELESTIAL
Hepatocellular carcinoma (HCC)
Indirect treatment comparison
Matching-adjusted indirect comparison (MAIC)
Issue Date2020
PublisherSpringer Healthcare Communications Ltd. The Journal's web site is located at http://www.springerhealthcare.com/ait/index.htm
Citation
Advances in Therapy, 2020, v. 37, p. 2678-2695 How to Cite?
AbstractBackground: No trials have compared cabozantinib and regorafenib for the second-line treatment of advanced hepatocellular carcinoma (HCC). Objectives: Conduct a matching-adjusted indirect comparison (MAIC) of the efficacy and safety of second-line cabozantinib and regorafenib in patients with advanced HCC and disease progression after prior sorafenib. Methods: The CELESTIAL and RESORCE trials were used for indirect comparison of second-line cabozantinib and regorafenib in advanced HCC. Population-level data were available for RESORCE, individual patient data (IPD) for CELESTIAL. To align with RESORCE, the CELESTIAL population was limited to patients who received first-line sorafenib only. To minimize potential effect-modifying population differences, the CELESTIAL IPD were weighted to balance the distribution of clinically relevant baseline characteristics with those of RESORCE. Overall survival (OS) and progression-free survival (PFS) were evaluated for the matching-adjusted second-line CELESTIAL population and compared with those for RESORCE using weighted Kaplan-Meier curves and parametric modeling. Rates of grade 3/4 treatment-emergent adverse events (TEAEs) affecting > 5% of patients in any study arm were compared. Results: In the matching-adjusted second-line populations (CELESTIAL, effective sample size = 266; RESORCE, n = 573), median (95% confidence interval) OS was similar for cabozantinib and regorafenib (11.4 [8.9–17.0] versus 10.6 [9.1–12.1] months; p = 0.3474, log-rank test). Median PFS was longer for cabozantinib than regorafenib (5.6 [4.9–7.3] versus 3.1 [2.8–4.2] months; p = 0.0005, log-rank test). There was a trend for lower rates of some grade 3/4 TEAEs with regorafenib than with cabozantinib, which may reflect the exclusion of sorafenib-intolerant patients from RESORCE but not from CELESTIAL, a difference that the MAIC methods could not remove. Only diarrhea rates were statistically significantly lower for regorafenib (p  ≤ 0.001). Conclusions: Cabozantinib may achieve similar OS and prolonged PFS compared with regorafenib in patients with progressive advanced HCC after prior sorafenib.
Descriptioneid_2-s2.0-85085394136
Persistent Identifierhttp://hdl.handle.net/10722/284096
ISSN
2020 Impact Factor: 3.845
2020 SCImago Journal Rankings: 1.097
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKelley, RK-
dc.contributor.authorMollon, P-
dc.contributor.authorBlanc, JF-
dc.contributor.authorDaniele, B-
dc.contributor.authorYau, T-
dc.contributor.authorCheng, AL-
dc.contributor.authorValcheva, V-
dc.contributor.authorMarteau, F-
dc.contributor.authorGuerra, I-
dc.contributor.authorAbou-Alfa, GK-
dc.date.accessioned2020-07-20T05:56:03Z-
dc.date.available2020-07-20T05:56:03Z-
dc.date.issued2020-
dc.identifier.citationAdvances in Therapy, 2020, v. 37, p. 2678-2695-
dc.identifier.issn0741-238X-
dc.identifier.urihttp://hdl.handle.net/10722/284096-
dc.descriptioneid_2-s2.0-85085394136-
dc.description.abstractBackground: No trials have compared cabozantinib and regorafenib for the second-line treatment of advanced hepatocellular carcinoma (HCC). Objectives: Conduct a matching-adjusted indirect comparison (MAIC) of the efficacy and safety of second-line cabozantinib and regorafenib in patients with advanced HCC and disease progression after prior sorafenib. Methods: The CELESTIAL and RESORCE trials were used for indirect comparison of second-line cabozantinib and regorafenib in advanced HCC. Population-level data were available for RESORCE, individual patient data (IPD) for CELESTIAL. To align with RESORCE, the CELESTIAL population was limited to patients who received first-line sorafenib only. To minimize potential effect-modifying population differences, the CELESTIAL IPD were weighted to balance the distribution of clinically relevant baseline characteristics with those of RESORCE. Overall survival (OS) and progression-free survival (PFS) were evaluated for the matching-adjusted second-line CELESTIAL population and compared with those for RESORCE using weighted Kaplan-Meier curves and parametric modeling. Rates of grade 3/4 treatment-emergent adverse events (TEAEs) affecting > 5% of patients in any study arm were compared. Results: In the matching-adjusted second-line populations (CELESTIAL, effective sample size = 266; RESORCE, n = 573), median (95% confidence interval) OS was similar for cabozantinib and regorafenib (11.4 [8.9–17.0] versus 10.6 [9.1–12.1] months; p = 0.3474, log-rank test). Median PFS was longer for cabozantinib than regorafenib (5.6 [4.9–7.3] versus 3.1 [2.8–4.2] months; p = 0.0005, log-rank test). There was a trend for lower rates of some grade 3/4 TEAEs with regorafenib than with cabozantinib, which may reflect the exclusion of sorafenib-intolerant patients from RESORCE but not from CELESTIAL, a difference that the MAIC methods could not remove. Only diarrhea rates were statistically significantly lower for regorafenib (p  ≤ 0.001). Conclusions: Cabozantinib may achieve similar OS and prolonged PFS compared with regorafenib in patients with progressive advanced HCC after prior sorafenib.-
dc.languageeng-
dc.publisherSpringer Healthcare Communications Ltd. The Journal's web site is located at http://www.springerhealthcare.com/ait/index.htm-
dc.relation.ispartofAdvances in Therapy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCabozantinib-
dc.subjectCELESTIAL-
dc.subjectHepatocellular carcinoma (HCC)-
dc.subjectIndirect treatment comparison-
dc.subjectMatching-adjusted indirect comparison (MAIC)-
dc.titleComparative Efficacy of Cabozantinib and Regorafenib for Advanced Hepatocellular Carcinoma-
dc.typeArticle-
dc.identifier.emailYau, T: tyaucc@hku.hk-
dc.identifier.authorityYau, T=rp01466-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s12325-020-01378-y-
dc.identifier.pmid32424805-
dc.identifier.scopuseid_2-s2.0-85085394136-
dc.identifier.hkuros311473-
dc.identifier.volume37-
dc.identifier.spage2678-
dc.identifier.epage2695-
dc.identifier.isiWOS:000533822200001-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0741-238X-

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