1007P - Network meta-analysis (NMA) of lenvatinib vs key comparators in first-line unresectable hepatocellular carcinoma (uHCC)

Background

This research compared the relative efficacy of lenvatinib monotherapy (mono), a standard of care for treatment of uHCC, versus approved / anticipated comparators. Using inverse probability of treatment weighting (IPTW) and an NMA, updated evidence for lenvatinib mono from LEAP-002, in addition to evidence from REFLECT, were included in the analyses.

Methods

Randomized controlled trials (RCTs) were identified via systematic literature review. REFLECT and LEAP-002 investigated lenvatinib mono in uHCC, with patient-level data available for each, however, only REFLECT had a comparator arm of interest. To utilise all available lenvatinib data, the lenvatinib arm from LEAP-002 was adjusted to match aggregate data for confounding factors from REFLECT using IPTW. Weighted Cox regression including matching variables as covariates were used to derive hazard ratios (HRs) for OS and progression-free survival (PFS) comparing lenvatinib and sorafenib. The estimated HRs were included in fixed-effects Bayesian NMAs to compare lenvatinib and comparators. Scenario analyses explored alternative choices for IPTW estimators.

Results

Eight RCTs (including REFLECT) and adjusted data from LEAP-002, were included in the NMA. Lenvatinib demonstrated a significant improvement in OS compared with sorafenib, and significant improvement in PFS compared with sorafenib, tremelimumab + durvalumab, tislelizumab and durvalumab (Table).

Table: 1007P

NMA results for OS and PFS – lenvatinib vs comparator

Bold = significant resultAbbreviations: Crl, credible interval; HR, hazard ratio; OS, overall survival; PFS, progression-free survival

Conclusions

These results suggest that patients with uHCC treated with lenvatinib mono have similar or significantly improved OS and PFS when compared with other therapies.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Eisai Inc.

Funding

Eisai Inc.

Disclosure

D. Trueman: Financial Interests, Institutional, Full or part-time Employment, Source Health economics employees were commissioned by Eisai Inc. to perform this analysis.: Source Health Economics. K. Ndirangu: Financial Interests, Institutional, Full or part-time Employment: Eisai. A. Paine: Financial Interests, Institutional, Full or part-time Employment, Source Health economics employees were commissioned by Eisai Inc. to perform this analysis.: Source Health Economics. H. Pilkington: Financial Interests, Institutional, Full or part-time Employment, Source Health economics employees were commissioned by Eisai Inc. to perform this analysis.: Source Health Economics.