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Regorafenib versus cabozantinb as second-line treatment after sorafenib for unresectable hepatocellular carcinoma: matching-adjusted indirect comparison analysis

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Abstract
Background Recently, three published phase III trials highlighted the superiority of investigational drugs compared to placebo, thus leading to their approval in the second-line setting. We report here a MAIC of second-line MKI options for patients with HCC previously treated with sorafenib using individual real-world data of regorafenib and aggregate data of second-line cabozantinib from the CELESTIAL trial. Methods Data from 278 patients who received regorafenib as second-line therapy after sorafenib failure for unresectable HCC were used as IPD. Data inclusion were adapted to those reported in the CELESTIAL trial in the subset of patients who received sorafenib as the only prior therapy. Survival medians and rates were obtained from Kaplan-Meier curves, and differences between regorafenib and cabozantinib groups were explored through Cox regression adjusted for weights originating from MAIC. Results The median OS of the weighted regorafenib group was 11.1 months (IQR: 5.6-16.4) and 11.3 (IQR: 6.7-22.4) for cabozantinib; HR 0.83 (95%CI 0.62-1.09). The median PFS of the weighted regorafenib group was 3.0 months (IQR: 1.9-4.8) and 5.5 (IQR: 2.3-9.3) for cabozantinib; HR 0.50 (95%CI 0.41-0.62). In the subgroup who received prior sorafenib for < 3 months, the median OS of the regorafenib group was 6.5 months (IQR: 4.7-10.9) and 9.5 months (IQR: 5.9-18.2) for cabozantinib; HR 0.68 (95%CI 0.39-1.16). In the subgroup receiving prior sorafenib for 3 to < 6 months, the median OS of the regorafenib group was 8.0 months (IQR: 4.2-15.2) and 11.5 (IQR: 6.5-23.9) for cabozantinib; HR 0.66 (95%CI 0.42-1.02). In the subgroup receiving prior sorafenib for >= 6 months, the median OS of the regorafenib group was 13.4 (IQR: 8.1-46.5) and 12.3 (IQR: 6.6-22.9) for cabozantinib; HR 0.89 (95%CI 0.52-1.51). Conclusion Our results confirmed no differences between regorafenib and cabozantinib in terms of OS. However, in earlier progressors on prior sorafenib a larger benefit might be expected from cabozantinib treatment.
Author(s)
김형돈류백렬방영학유민희유창훈Alessandro CucchettiAndrea Casadei-GardiniAntonio PellinoCaterina VivaldiFrancesca Salanigherita RiminiGianluca MasiLorenza RimassaMario Domenico RizzatoSara LonardiSilvia CataneseStefano CascinuValentina Burgio
Issued Date
2021
Type
Article
Keyword
CELESTIALCabozantinibHepatocellular carcinoma (HCC)Indirect treatment comparisonMatching-adjusted indirect comparison (MAIC)RESORCERegorafenibSecond-lineSystemic therapyTargeted therapy.
DOI
10.1007/s00432-021-03602-w
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8419
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2503683092&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Regorafenib%20versus%20cabozantinb%20as%20second-line%20treatment%20after%20sorafenib%20for%20unresectable%20hepatocellular%20carcinoma:%20matching-adjusted%20indirect%20comparison%20analysis&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
Location
미국
Language
영어
ISSN
0171-5216
Citation Volume
147
Citation Number
12
Citation Start Page
3665
Citation End Page
3671
Appears in Collections:
Medicine > Medicine
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