Ars Accessus Medica, Rotterdam, The Netherlands.
Lung Cancer. 2010 Aug;69 Suppl 1:S4-10. doi: 10.1016/S0169-5002(10)70132-X.
The new targeted agent bevacizumab in combination with cisplatin and gemcitabine, and a third generation chemotherapy, pemetrexed, combined with cisplatin, are approved as first-line treatment for patients with advanced nonsquamous non-small cell lung cancer (NSCLC). As no head-to-head comparison of these treatments exists, this study aimed to compare the effectiveness of the two treatments using an indirect treatment comparison approach. An indirect comparison on progression-free survival (PFS) was performed for two relevant randomised controlled trials using a well-accepted adjusted indirect comparison method. The results were used in a statistical disease model (Markov model) to extrapolate the long-term effectiveness of the two treatments. A hazard ratio of 0.83 for PFS for bevacizumab plus cisplatin and gemcitabine, was calculated suggesting that this treatment is associated with a 17% lower risk of disease progression and death compared with pemetrexed plus cisplatin treatment. The Markov model predicted that bevacizumab plus cisplatin and gemcitabine resulted in 2.5 months additional PFS and overall survival compared with pemetrexed plus cisplatin. Based on this analysis bevacizumab plus cisplatin and gemcitabine is more effective than pemetrexed plus cisplatin for patients with advanced non-squamous NSCLC and should be considered as one of the preferred targeted treatments of choice for these patients.
贝伐珠单抗联合顺铂和吉西他滨，以及第三代化疗药物培美曲塞联合顺铂，被批准用于晚期非鳞状非小细胞肺癌（NSCLC）患者的一线治疗。由于这些治疗方法之间没有直接的比较，因此本研究旨在使用间接治疗比较方法来比较这两种治疗方法的有效性。使用一种公认的调整后间接比较方法，对两项相关的随机对照试验进行了无进展生存期（PFS）的间接比较。结果用于统计疾病模型（马尔可夫模型）中，以推断两种治疗方法的长期疗效。贝伐珠单抗联合顺铂和吉西他滨治疗的 PFS 风险比为 0.83，这表明与培美曲塞联合顺铂治疗相比，这种治疗方法与疾病进展和死亡风险降低 17%相关。马尔可夫模型预测，与培美曲塞联合顺铂治疗相比，贝伐珠单抗联合顺铂和吉西他滨可使 PFS 和总生存期分别延长 2.5 个月。基于这项分析，贝伐珠单抗联合顺铂和吉西他滨对晚期非鳞状 NSCLC 患者比培美曲塞联合顺铂更有效，应被视为这些患者的首选靶向治疗方法之一。
