An Exploratory Analysis of Real-World End Points for Assessing Outcomes Among Immunotherapy-Treated Patients With Advanced Non-Small-Cell Lung Cancer
- PMID: 31335166
- PMCID: PMC6873914
- DOI: 10.1200/CCI.18.00155
An Exploratory Analysis of Real-World End Points for Assessing Outcomes Among Immunotherapy-Treated Patients With Advanced Non-Small-Cell Lung Cancer
Abstract
Purpose: This pilot study examined the ability to operationalize the collection of real-world data to explore the potential use of real-world end points extracted from data from diverse health care data organizations and to assess how these relate to similar end points in clinical trials for immunotherapy-treated advanced non-small-cell lung cancer.
Patients and methods: Researchers from six organizations followed a common protocol using data from administrative claims and electronic health records to assess real-world end points, including overall survival (rwOS), time to next treatment, time to treatment discontinuation (rwTTD), time to progression, and progression-free survival, among patients with advanced non-small-cell lung cancer treated with programmed death 1/programmed death-ligand 1 inhibitors in real-world settings. Data sets included from 269 to 6,924 patients who were treated between January 2011 and October 2017. Results from contributors were anonymized.
Results: Correlations between real-world intermediate end points (rwTTD and time to next treatment) and rwOS were moderate to high (range, 0.6 to 0.9). rwTTD was the most consistent end points as treatment detail was available in all data sets. rwOS at 1 year post-programmed death-ligand 1 initiation ranged from 40% to 57%. In addition, rwOS as assessed via electronic health records and claims data fell within the range of median OS values observed in relevant clinical trials. Data sources had been used extensively for research with ongoing data curation to assure accuracy and practical completeness before the initiation of this research.
Conclusion: These findings demonstrate that real-world end points are generally consistent with each other and with outcomes observed in randomized clinical trials, which substantiates the potential validity of real-world data to support regulatory and payer decision making. Differences observed likely reflect true differences between real-world and protocol-driven practices.
Conflict of interest statement
Andrew D. Norden
Henry Joe Henk
Amy P. Abernethy
Aaron S. Mansfield
Srikesh Arunajadai
Jennifer B. Christian
Rebecca A. Miksad
Lori C. Sakoda
Aracelis Z. Torres
No other potential conflicts of interest were reported.
Comment in
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Practical Application of Real-World Evidence in Developing Cancer Therapies.JCO Clin Cancer Inform. 2019 Jul;3:1-2. doi: 10.1200/CCI.19.00071. JCO Clin Cancer Inform. 2019. PMID: 31335165 Free PMC article. No abstract available.
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References
-
- Martin L, Hutchens M, Hawkins C, et al. How much do clinical trials cost? Nat Rev Drug Discov. 2017;16:381–382. - PubMed
-
- Frieden TR. Evidence for health decision making: Beyond randomized, controlled trials. N Engl J Med. 2017;377:465–475. - PubMed
-
- Franklin JM, Schneeweiss S. When and how can real world data analyses substitute for randomized controlled trials? Clin Pharmacol Ther. 2017;102:924–933. - PubMed
-
- Ali AK, Hartzema AG.(eds)Enriched Studies inPost-Authorization Safety Studies of Medicinal Products: The PASS Book ed 1London, United Kingdom: Elsevier; 2018. pp150–158.
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