Number Needed to Treat (NNT) Comparing Axicabtagene Ciloleucel and Best Supportive Care for Third Line Diffuse Large B-Cell Lymphoma in Brazil

Speaker(s)

Asano E1, Nakada C2, Bezerra J3, Nascimento Junior RR4
1Origin Health Intelligence, Brazil, São Paulo, Brazil, 2Gilead Sciences, São Paulo, SP, Brazil, 3Gilead Sciences, São Paulo, Brazil, 4TNK, CURITIBA, PR, Brazil

OBJECTIVES: In this study we assessed the relative benefit in overall survival of axicabtagene ciloleucel (axi-cel) versus best supportive care (BSC) in the treatment of adult patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL), after two or more lines of systemic therapy, using the number needed to treat (NNT) for one additional survivor.

METHODS: We used two different NNT calculation methods to compare axi-cel and BSC in R/R LBCL. Absolute risk reduction (ARR) and restricted mean survival time (RMST) values for overall survival (OS) at 12, 24 and 32 months (time from onset of salvage therapy) follow-up were extracted from a published propensity score matching study comparing axi-cel to BSC based on clinical outcomes reported in the ZUMA-1 clinical trial (NCT02348216) and the SCHOLAR-1 retrospective cohort study. The NNTs were then calculated in two ways: first, using the inverse of the absolute risk reduction (NNTARR) and then using a restricted mean survival time approach (NNTRMST) to capture the profile of the treatment effect over time.

RESULTS: Axi-cel was associated with an incremental RMST of 4.28 months (NNTRMST = 1.53; 95% IC 1.26 to 1.91) compared to BSC at 12 months, incremental RMST of 9.01 months (NNTRMST = 1.02; 95% IC 0.80 to 1.37) at 24 months, and an incremental 11.59 months (NNTRMST = 0.93; 95% IC 0.70 to 1.29) at 32 months. Calculations for NNTARR were 2.22, 2.94 and 5.10 at 12, 24 and 32 months, respectively.

CONCLUSIONS: Our results demonstrated a low NNTRMST for axi-cel compared to BSC indicating the potential to prevent an extra death for every DLBCL patient treated with axi-cel. Our findings may be useful for decision making in treatment allocation for R/R LBCL.

Code

EE682

Topic

Economic Evaluation

Topic Subcategory

Value of Information

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Oncology