A matching-adjusted indirect comparison of pembrolizumab + chemotherapy vs nivolumab + ipilimumab as first-line therapies in patients with PD-L1 TPS ≥1% metastatic NSCLC

Balazs Halmos, Thomas Burke, Chrysostomos Kalyvas, Ralph Insinga, Kristel Vandormael, Andrew Frederickson, Bilal Piperdi

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: In the absence of head-to-head trials, this study indirectly compared the effectiveness of pembrolizumab + chemotherapy vs nivolumab + ipilimumab for the first-line treatment of metastatic stage IV NSCLC patients with PD-L1 tumor proportion score (TPS) ≥1%. Methods: An anchored matching-adjusted indirect comparison (MAIC) was conducted using pooled individual patient data (IPD) from the ITT population in KEYNOTE-021G, KEYNOTE-189 and KEYNOTE-407 (n = 816) and published aggregate data of nivolumab + ipilimumab from CheckMate 227 Part 1A (n = 793). To adjust for cross-trial differences in baseline characteristics, data from KEYNOTE-021G/KEYNOTE-189/KEYNOTE-407 were re-weighted to match the baseline characteristics of CheckMate 227 Part 1A. Outcomes included OS, PFS and ORR. Base case analyses were restricted to patients with PD-L1 TPS ≥1%, with sub-group analyses in PD-L1 TPS ≥50% and 1–49%. Results: The estimated HR (95% CI) of pembrolizumab + chemotherapy vs nivolumab + ipilimumab was 0.80 (0.59,1.09) and 0.53 (0.41,0.68) for OS and PFS, respectively. For ORR, the estimated risk ratio was 1.8 (1.3,2.4) for pembrolizumab + chemotherapy vs nivolumab + ipilimumab and the risk difference was 25.5% (15.0,36.0). PD-L1 TPS ≥50% and 1–49% sub-groups showed an OS HR of 0.89 (0.58,1.36) and 0.68 (0.46,1.01), respectively. Conclusion: These MAIC results suggest that pembrolizumab + chemotherapy leads to a greater clinical benefit vs nivolumab + ipilimumab in patients with PD-L1 TPS ≥1% across multiple endpoints.

Original languageEnglish (US)
Article number3648
Pages (from-to)1-15
Number of pages15
JournalCancers
Volume12
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • Chemotherapy
  • Comparative effectiveness
  • Matching-adjusted indirect comparison
  • Nivolumab
  • Non-small cell lung cancer
  • Pembrolizumab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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