346P - An estimation of the population survival benefit of first-course chemotherapy and immunotherapy for leukemia

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer agents
Leukaemia
Immunotherapy
Presenter Viet Do
Citation Annals of Oncology (2016) 27 (suppl_9): ix104-ix111. 10.1093/annonc/mdw586
Authors V. Do1, S. Jacob2, W. Ng2, G.P. Delaney2, M.B. Barton2
  • 1Swron, The Crown Princess Mary Cancer Centre, 2145 - Westmead/AU
  • 2Collaboration For Cancer Outcomes Research And Evaluation (ccore), Ingham Institute for Applied Medical Research, University of New South Wales, 2170 - Liverpool/AU

Abstract

Background

Randomized clinical trials describe the benefit of chemo-and immunotherapy for specific leukemia patients with selected patient and disease characteristics. The overall survival benefit for the whole population of leukemia patients in Australia if evidence-based guidelines for chemo-and immunotherapy were implemented routinely is unknown. Our study’s purpose was to estimate the overall population survival benefit of applying evidence-based practice.

Methods

Decision trees with evidence-based indications for chemotherapy have been previously defined for leukemia. Each branch corresponds to a specific cohort who have, or do not have, defined indications for chemotherapy and/or immunotherapy. Chemo-and immunotherapy benefit was defined as the absolute incremental benefit of either chemotherapy and/or immunotherapy over no chemo- and/or immunotherapy for radical and palliative indications. Multiple electronic citation databases were systematically queried, including Medline and the Cochrane Library. In cases where there were multiple sources of the same level of evidence, hierarchical meta-analysis was performed. The benefits of chemo-and immunotherapy were estimated for 1, 5-year survival. To assess the robustness of our estimates, sensitivity analyses were performed.

Results

The estimated 1-year and 5-year absolute population-based overall survival benefits of optimally utilized first-course chemo- and immunotherapy for leukemia in Australia are 19.4% (95% Confidence Interval (CI), 19.2%-19.6%), and 19.7% (95% CI, 19.3%-20.0%), respectively. They are summarized in the table.rn

Table: 346P

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
Leukemia% subtypes Estimated 1-yr OS benefitEstimated 5yr OS benefit
CLL37.8%0.02%0.08%
AML30.8%50.30%29.20%
ALL13.8%18.60%16.30%
CML14.5%0.04%37.60%
All Leukemiarn19.4% (95% CI 19.2%-19.6%)19.7% (95% CI 19.3%-20.0%)
rn

Conclusions

Chemo- and immunotherapy agents improves overall survival in leukemia at 1- and 5-years. Chemo-and immunotherapy provides an important survival benefit to this patient population in Australia when it is used in accordance with guideline recommendations.

Clinical trial indentification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.