The added value of multi-state modelling in a randomized controlled trial
| Autor: | Katerina Bakunina, Hein Putter, Jurjen Versluis, Eva A. S. Koster, Bronno Holt, Markus G. Manz, Dimitri A. Breems, Bjorn T. Gjertsen, Jacqueline Cloos, Peter J. M. Valk, Jakob Passweg, Thomas Pabst, Gert J. Ossenkoppele, Bob Löwenberg, Jan J. Cornelissen, Liesbeth C. Wreede |
|---|---|
| Přispěvatelé: | Hematology, Hematology laboratory, CCA - Cancer biology and immunology, CCA - Imaging and biomarkers, CCA - Cancer Treatment and quality of life, University of Zurich, Bakunina, Katerina |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
multi‐state model current leukemia‐free survival 610 Medicine & health multi-state model SDG 3 - Good Health and Well-being AML Recurrence 2741 Radiology Nuclear Medicine and Imaging Humans Radiology Nuclear Medicine and imaging 1306 Cancer Research RC254-282 Remission Induction Hematopoietic Stem Cell Transplantation Neoplasms. Tumors. Oncology. Including cancer and carcinogens current leukemia-free survival Leukemia Myeloid Acute Treatment Outcome Oncology clofarabine 10032 Clinic for Oncology and Hematology HSCT 2730 Oncology RCT |
| Zdroj: | Bakunina, Katerina; Putter, Hein; Versluis, Jurjen; Koster, Eva A S; van der Holt, Bronno; Manz, Markus G; Breems, Dimitri A; Gjertsen, Bjorn T; Cloos, Jacqueline; Valk, Peter J M; Passweg, Jakob; Pabst, Thomas; Ossenkoppele, Gert J; Löwenberg, Bob; Cornelissen, Jan J; de Wreede, Liesbeth C (2022). The added value of multi-state modelling in a randomized controlled trial: The HOVON 102 study re-analyzed. Cancer medicine, 11(3), pp. 630-640. Wiley 10.1002/cam4.4392 Cancer Medicine, 11(3), 630-640. WILEY Cancer Medicine, Vol 11, Iss 3, Pp 630-640 (2022) Cancer Medicine Cancer Medicine, 11(3), 630-640. John Wiley & Sons Ltd. Bakunina, K, Putter, H, Versluis, J, Koster, E A S, van der Holt, B, Manz, M G, Breems, D A, Gjertsen, B T, Cloos, J, Valk, P J M, Passweg, J, Pabst, T, Ossenkoppele, G J, Löwenberg, B, Cornelissen, J J & de Wreede, L C 2021, ' The added value of multi-state modelling in a randomized controlled trial : The HOVON 102 study re-analyzed ', Cancer Medicine . https://doi.org/10.1002/cam4.4392 Cancer Medicine. John Wiley and Sons Ltd |
| ISSN: | 2045-7634 |
| DOI: | 10.1002/cam4.4392 |
| Popis: | Clofarabine is an active antileukemic drug for subgroups of patients with acute myeloid leukemia (AML). Multi-state models can provide additional insights to supplement the original intention-to-treat analysis of randomized controlled trials (RCT). We re-analyzed the HOVON102/SAKK30/09 phase III RCT for newly diagnosed AML patients, which randomized between standard induction chemotherapy with or without clofarabine. Using multi-state models, we evaluated the effects of induction chemotherapy outcomes (complete remission [CR], measurable residual disease [MRD]), and post-remission therapy with allogeneic stem cell transplantation [alloSCT] on relapse and death. Through the latter a consistent reduction in the hazard of relapse in the clofarabine arm compared to the standard arm was found, which occurred irrespective of MRD status or post-remission treatment with alloSCT, demonstrating a strong and persistent antileukemic effect of clofarabine. During the time period between achieving CR and possible post-remission treatment with alloSCT, non-relapse mortality was higher in patients receiving clofarabine. An overall net benefit of treatment with clofarabine was identified using the composite endpoint current leukemia-free survival (CLFS). In conclusion, these results enforce and extend the earlier reported beneficial effect of clofarabine in AML and show that multi-state models further detail the effect of treatment on competing and series of events. publishedVersion |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|