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Addressing challenges with real-world synthetic control arms to demonstrate the comparative effectiveness of Pralsetinib in non-small cell lung cancer

Author

Listed:
  • Sanjay Popat

    (Royal Marsden Hospital and Institute of Cancer Research)

  • Stephen V. Liu

    (Georgetown University)

  • Nicolas Scheuer

    (Roche Products Ltd)

  • Grace G. Hsu

    (Cytel, Inc)

  • Alexandre Lockhart

    (Cytel, Inc)

  • Sreeram V. Ramagopalan

    (Global Access, F. Hoffmann-La Roche)

  • Frank Griesinger

    (Pius-Hospital Oldenburg)

  • Vivek Subbiah

    (The University of Texas MD Anderson Cancer Center)

Abstract

As advanced non-small cell lung cancer (aNSCLC) is being increasingly divided into rare oncogene-driven subsets, conducting randomised trials becomes challenging. Using real-world data (RWD) to construct control arms for single-arm trials provides an option for comparative data. However, non-randomised treatment comparisons have the potential to be biased and cause concern for decision-makers. Using the example of pralsetinib from a RET fusion-positive aNSCLC single-arm trial (NCT03037385), we demonstrate a relative survival benefit when compared to pembrolizumab monotherapy and pembrolizumab with chemotherapy RWD cohorts. Quantitative bias analyses show that results for the RWD-trial comparisons are robust to data missingness, potential poorer outcomes in RWD and residual confounding. Overall, the study provides evidence in favour of pralsetinib as a first-line treatment for RET fusion-positive aNSCLC. The quantification of potential bias performed in this study can be used as a template for future studies of this nature.

Suggested Citation

  • Sanjay Popat & Stephen V. Liu & Nicolas Scheuer & Grace G. Hsu & Alexandre Lockhart & Sreeram V. Ramagopalan & Frank Griesinger & Vivek Subbiah, 2022. "Addressing challenges with real-world synthetic control arms to demonstrate the comparative effectiveness of Pralsetinib in non-small cell lung cancer," Nature Communications, Nature, vol. 13(1), pages 1-10, December.
  • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-30908-1
    DOI: 10.1038/s41467-022-30908-1
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    References listed on IDEAS

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    1. David M. Phillippo & Anthony E. Ades & Sofia Dias & Stephen Palmer & Keith R. Abrams & Nicky J. Welton, 2018. "Methods for Population-Adjusted Indirect Comparisons in Health Technology Appraisal," Medical Decision Making, , vol. 38(2), pages 200-211, February.
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