EVALUATING THE EFFECT OF IMMUNOTHERAPY IN ADVANCED NON-SMALL- CELL LUNG CANCER PATIENTS USING TWO COMPONENTS MIXTURE MODEL
Author(s)
Sánchez L1, Muchene L2, Luaces P1, Viada C1, Rodríguez PC1, Frias A1, Shkedy Z2, Lage A1
1Center of Molecular Immunology, Havana, Cuba, 2Hasselt University, Diepenbeek, Belgium
OBJECTIVES: The aim of the study was to assess the effect of an immunotherapy for the treatment of advanced non–small-cell lung cancer (NSCLC). METHODS: Data from a phase III, multicenter, randomized, open-label trial evaluating the efficacy of one EGF-based cancer vaccine (CIMAvaxEGF) as switch maintenance in patients with advanced NSCLC, were used. Survival analysis using Kaplan Meier estimates was performed. Weighted log-rank was conducted to assess the later effect of the immunotherapy. Additionally, a finite mixture model to the primary endpoint (Overall Survival, OS) was fitted. Weibull distribution was assumed for the overall survival and a mixture model consists of one, two or three components was fitted.. All analysis was conducted using the NLMIXED procedure in SAS. The Akaike Information Criterion (AIC) was used for model selection. RESULTS: Intention-to-treat (ITT) analysis showed 1.44 months of OS benefit for vaccinated patients with confirmed delayed-separation phenomena (OS: Vaccine arm, 10.37 months vs. Control arm, 8.93 months; p= 0.043). The mixture model with the best goodness to fit to the data consists of two components (AIC=3097.7). The two mixture components represent short-term and long-term survival subpopulations. The proportions of the subpopulations are estimated to be equal to 0.89 and 0.11 respectively. The median OS was estimated to be equal to 9.59 and 60.32 for short- and long- term survival populations, respectively. 23.26% and 76.74% from the patients who were classified into long-term survival subpopulation were from the control and vaccinated group, respectively. From them, 7 (70%) patients in the control group and 25 (75%) patients in the treated group were still alive at the end of the study. CONCLUSIONS: The results confirm that the vaccination with CIMAvaxEGF prolongs the survival of the advanced NSCLC patients. Mixture models allow assessing the efficacy/effectiveness of vaccines and biological products in the presence of heterogeneous populations.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PRM132
Topic
Methodological & Statistical Research
Topic Subcategory
Confounding, Selection Bias Correction, Causal Inference, Modeling and simulation
Disease
Oncology