Assessing Causal Treatment Effect for Sequenced Oncology Regimens

July 13, 2023

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Title: Assessing Causal Treatment Effect for Sequenced Oncology Regimens 

Thursday, July 13, 2023
10:00AM EDT | 2:00PM UTC | 4:00PM CEST

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In oncology, sequential use of treatments with different mechanisms of action is common practice to overcome cross-resistance  . Over the past decade, treatment sequencing with novel immunotherapy and targeted agents has contributed to substantial improvement in clinical outcomes in cancer patients. However, such clinical practice introduces methodology challenges for HTA. 

There are two main reasons why assessing causal treatment effects can be complex during treatment sequencing. First, the effectiveness of a specific treatment is often dependent on prior lines of treatments and their failures. Specifically, effectiveness of a treatment can be diminished if a patient had disease progression with a previous treatment with similar mechanisms of action. 

Second, overall survival is jointly determined by effectiveness of all lines of treatments. If a patient in a clinical trial has disease progression while receiving a treatment, the patient will likely switch to another treatment or receive a subsequent line of therapy. Essentially, it is challenging to evaluate the effectiveness of treatment B when one group of patients receives treatments A, B, and C sequentially and another group of patients receives treatment D, B, and E.

In recent appraisals from The National Institute for Health and Care Excellence (NICE), UK, the inability to adjust for prior and subsequent lines of treatment in cancer patients has been criticized. The webinar aims to introduce challenges associated with assessing causal treatment effect for treatment sequencing in oncology in layman’s terms and discuss potential approaches to address such challenges.

This webinar is hosted by the ISPOR Oncology Special Interest Group (SIG), with Professor Uwe Siebert leading. Professor Siebert is Chair of the Department of Public Health, Health Services Research and HTA at UMIT TIROL - University for Health Sciences and Technology in Hall in Tirol, Austria. He is also Adjunct Professor of Epidemiology and Health Policy & Management at the Harvard Chan School of Public Health, Boston, MA, USA.

Learning Objectives

  • Understand methodological challenges in assessing causal treatment effects during treatment sequencing in oncology.
  • Identify how these methodological issues pose limitations to health technology assessment.
  • Explain potential approaches to estimating causal treatment effect during treatment sequencing in oncology.


Uwe Siebert, MD, MPH, MSc, ScD, Chair, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Tirol, Austria

Abeer Al Rabayah, BSc, MBA, MSc, PMP, Head, Center for Drug Policy and Technology Assessment, King Hussein Cancer Foundation and Center, Amman, Jordan

Brought to you by: ISPOR Oncology Special Interest Group

Please note:
On the day of the scheduled webinar, the first 1000 registered participants will be accepted into the webinar. For those who are unable to attend, or would like to review the webinar at a later date, the full-length webinar recording will be made available at the ISPOR Educational Webinar Series webpage approximately 2 days after the scheduled Webinar.

Reservations are on a first-come, first-served basis.

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