Title
How comparable are patient outcomes in the "real-world" with populations studied in pivotal AML trials?
Link to article in PubMed
Author(s)
Tiong, Ing Soo
Wall, Meaghan
Bajel, Ashish
Kalro, Akash
Fleming, Shaun
Roberts, Andrew W
Thiagarajah, Nisha
Chua, Chong Chyn
Latimer, Maya
Yeung, David
Marlton, Paula
Johnston, Amanda
Enjeti, Anoop
Fong, Chun Yew
Cull, Gavin
Larsen, Stephen
Kennedy, Glen
Schwarer, Anthony
Kipp, David
Ramanathan, Sundra
Verner, Emma
Tiley, Campbell
Morris, Edward
Hahn, Uwe
Moore, John
Taper, John
Purtill, Duncan
Warburton, Pauline
Stevenson, William
Murphy, Nicholas
Tan, Peter
Beligaswatte, Ashanka
Mutsando, Howard
Hertzberg, Mark
Shortt, Jake
Dunne, Karin
Wei, Andrew H
Abstract
Despite an increasing desire to use historical cohorts as "synthetic" controls for new drug evaluation, limited data exist regarding the comparability of real-world outcomes to those in clinical trials. Governmental cancer data often lacks details on treatment, response, and molecular characterization of disease sub-groups. The Australasian Leukaemia and Lymphoma Group National Blood Cancer Registry (ALLG NBCR) includes source information on morphology, cytogenetics, flow cytometry, and molecular features linked to treatment received (including transplantation), response to treatment, relapse, and survival outcome. Using data from 942 AML patients enrolled between 2012-2018, we assessed age and disease-matched control and interventional populations from published randomized trials that led to the registration of midostaurin, gemtuzumab ozogamicin, CPX-351, oral azacitidine, and venetoclax. Our analyses highlight important differences in real-world outcomes compared to clinical trial populations, including variations in anthracycline type, cytarabine intensity and scheduling during consolidation, and the frequency of allogeneic hematopoietic cell transplantation in first remission. Although real-world outcomes were comparable to some published studies, notable differences were apparent in others. If historical datasets were used to assess the impact of novel therapies, this work underscores the need to assess diverse datasets to enable geographic differences in treatment outcomes to be accounted for.
Publication information
Blood Cancer J . 2024 Mar 26;14(1):54. doi: 10.1038/s41408-024-00996-x.
Date Issued
2024-03-25
Type
Journal Article
Journal Title
Blood cancer journal
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