How comparable are patient outcomes in the "real-world" with populations studied in pivotal AML trials?


Journal

Blood cancer journal
ISSN: 2044-5385
Titre abrégé: Blood Cancer J
Pays: United States
ID NLM: 101568469

Informations de publication

Date de publication:
26 Mar 2024
Historique:
received: 22 10 2023
accepted: 24 01 2024
revised: 21 01 2024
medline: 27 3 2024
pubmed: 27 3 2024
entrez: 27 3 2024
Statut: epublish

Résumé

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.

Identifiants

pubmed: 38531863
doi: 10.1038/s41408-024-00996-x
pii: 10.1038/s41408-024-00996-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

54

Informations de copyright

© 2024. The Author(s).

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Auteurs

Ing Soo Tiong (IS)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
The Alfred Hospital, Melbourne, VIC, Australia.
Monash University, Melbourne, VIC, Australia.

Meaghan Wall (M)

Monash University, Melbourne, VIC, Australia.
Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia.

Ashish Bajel (A)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Royal Melbourne Hospital, Parkville, VIC, Australia.
The University of Melbourne, Melbourne, VIC, Australia.

Akash Kalro (A)

Royal Adelaide Hospital, Adelaide, SA, Australia.

Shaun Fleming (S)

The Alfred Hospital, Melbourne, VIC, Australia.

Andrew W Roberts (AW)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Royal Melbourne Hospital, Parkville, VIC, Australia.
The University of Melbourne, Melbourne, VIC, Australia.
Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.

Nisha Thiagarajah (N)

Royal Melbourne Hospital, Parkville, VIC, Australia.

Chong Chyn Chua (CC)

The Alfred Hospital, Melbourne, VIC, Australia.
Monash University, Melbourne, VIC, Australia.
The Northern Hospital, Epping, VIC, Australia.

Maya Latimer (M)

Canberra Hospital, Garran, ACT, Australia.
ACT Pathology, Garran, ACT, Australia.
Australian National University, Canberra, ACT, Australia.

David Yeung (D)

Royal Adelaide Hospital, Adelaide, SA, Australia.
South Australian Health and Medical Research Institute, Adelaide, SA, Australia.

Paula Marlton (P)

Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
University of Queensland, Brisbane, QLD, Australia.

Amanda Johnston (A)

Westmead Hospital, Westmead, NSW, Australia.

Anoop Enjeti (A)

Calvary Mater Newcastle, Waratah, NSW, Australia.

Chun Yew Fong (CY)

Austin Hospital, Heidelberg, VIC, Australia.

Gavin Cull (G)

Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
PathWest Laboratory Medicine, Nedlands, WA, Australia.
University of Western Australia, Perth, WA, Australia.

Stephen Larsen (S)

Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Glen Kennedy (G)

Royal Brisbane and Women's Hospital, Herston, QLD, Australia.

Anthony Schwarer (A)

Box Hill Hospital, Box Hill, VIC, Australia.

David Kipp (D)

Barwon Health, Geelong, VIC, Australia.

Sundra Ramanathan (S)

St George Hospital, Kogarah, NSW, Australia.

Emma Verner (E)

Concord Hospital, Concord, NSW, Australia.

Campbell Tiley (C)

Gosford Hospital, Gosford, NSW, Australia.
University of Newcastle, Callaghan, NSW, Australia.

Edward Morris (E)

Townsville University Hospital, Douglas, QLD, Australia.

Uwe Hahn (U)

Royal Adelaide Hospital, Adelaide, SA, Australia.
The Queen Elizabeth Hospital, Woodville South, SA, Australia.
SA Pathology, Adelaide, SA, Australia.

John Moore (J)

St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.

John Taper (J)

Nepean Hospital, Kingswood, NSW, Australia.

Duncan Purtill (D)

PathWest Laboratory Medicine, Nedlands, WA, Australia.
Fiona Stanley Hospital, Murdoch, WA, Australia.

Pauline Warburton (P)

Wollongong Hospital, Wollongong, NSW, Australia.

William Stevenson (W)

Royal North Shore Hospital, St Leonards, NSW, Australia.
Northern Clinical School, University of Sydney, Sydney, NSW, Australia.

Nicholas Murphy (N)

Royal Hobart Hospital, Hobart, TAS, Australia.

Peter Tan (P)

Royal Perth Hospital, Perth, WA, Australia.

Ashanka Beligaswatte (A)

Royal Adelaide Hospital, Adelaide, SA, Australia.
Flinders Medical Centre, Bedford Park, SA, Australia.
Flinders University, Bedford Park, SA, Australia.

Howard Mutsando (H)

Toowoomba Hospital, Toowoomba, QLD, Australia.

Mark Hertzberg (M)

Prince of Wales Hospital, Randwick, NSW, Australia.

Jake Shortt (J)

Monash University, Melbourne, VIC, Australia.
Monash Medical Centre, Clayton, VIC, Australia.

Ferenc Szabo (F)

Royal Darwin Hospital, Tiwi, NT, Australia.

Karin Dunne (K)

Australasian Leukaemia and Lymphoma Group (ALLG), Melbourne, VIC, Australia.

Andrew H Wei (AH)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. andrew.wei@petermac.org.
Royal Melbourne Hospital, Parkville, VIC, Australia. andrew.wei@petermac.org.
The University of Melbourne, Melbourne, VIC, Australia. andrew.wei@petermac.org.
Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia. andrew.wei@petermac.org.

Classifications MeSH