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Clinical Trial Simulations From a Model‐Based Meta‐Analysis of Studies in Patients With Advanced Hepatocellular Carcinoma Receiving Antiangiogenic Therapy

机译:基于模型的荟萃分析的临床试验模拟用于接受抗血管生成治疗的晚期肝细胞癌患者

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摘要

A mixed effect model describing median overall survival (mOS) in patients with advanced hepatocellular carcinoma (aHCC) treated with antiangiogenic therapy (AAT) was developed from literature data. Data were extracted from 59 studies, representing 4,813 patients. The final model included estimates of mOS after AAT (8.5 months) or placebo (7.1 months) administration. The mOS increased 21% when the AAT was sorafenib (SOR) or 42% when locoregional therapy was coadministered. The mOS decreased when patients received prior systemic therapy (↓7%) or concomitant chemotherapy (↓4%) or the percentage of patients with hepatitis B increased (↓∼0.4%/%). Clinical trial simulations of a phase II comparative trial predicted an mOS ratio (placebo:AAT) of 0.687 or 0.831, with a 65% or 22% probability of demonstrating superiority, for SOR or other AATs, respectively. Additionally, the 95% confidence interval (CI) of the simulated median mOS ratio for non‐SOR AATs was similar to the 95% CI of the hazard ratio (HR) observed in the trial.
机译:从文献数据中得出了一个混合效应模型,该模型描述了用抗血管生成治疗(AAT)治疗的晚期肝细胞癌(aHCC)患者的中位总生存期(mOS)。数据来自59项研究,代表4,813例患者。最终模型包括AAT(8.5个月)或安慰剂(7.1个月)给药后的mOS估计值。当AAT为索拉非尼(SOR)时,mOS升高21%,而局部治疗联合给药时,mOS增加42%。当患者接受先前的全身治疗(↓7%)或同时进行化疗(↓4%)或乙肝患者的百分比增加(↓〜0.4%/%)时,mOS降低。一项II期比较试验的临床试验模拟预测,对于SOR或其他AAT,mOS比率(安慰剂:AAT)为0.687或0.831,分别具有65%或22%的优越性。此外,非SOR AAT的模拟中值mOS比率的95%置信区间(CI)与试验中观察到的危险比(HR)的95%CI相似。

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