Abstract 1417P
Background
Tislelizumab has demonstrated survival benefit over chemotherapy in previously treated advanced esophageal squamous cell carcinoma (ESCC) in an open-label phase 3 study (RATIONALE 302, N=512, NCT03430843). In the absence of head-to-head studies, anchored simulated treatment comparisons (STCs) estimated the relative effect of tislelizumab versus other anti-PD-1 treatments approved in the European Union and United Kingdom.
Methods
Individual patient data from RATIONALE 302 were adjusted to aggregate data in each comparator study using STC. Clinical expert input, statistical analyses and literature searches determined important effect modifiers. Depending on data availability, STCs for overall survival (OS) and progression-free survival (PFS) were adjusted for Eastern Cooperative Oncology Group performance status (ECOG-PS), disease status, PD-1 expression status, liver and lung metastasis; whereas STC for treatment-related adverse event (TRAE) grade ≥ 3 analysis was adjusted for age, ECOG-PS, PD-1 expression, liver metastasis, and previous therapies. Additional sensitivity analyses along with subgroup analyses (PD-1 category and baseline ECOG-PS) were considered. These analyses were also conducted using the latest DCO (Dec 28, 2022).
Results
Comparator studies were similar to RATIONALE 302 with comparable control arms. After adjustment, no significant differences were estimated in PFS, OS, or TRAEs between tislelizumab and anti-PD-1 comparators (Table). Results from sensitivity, subgroup and latest DCO aligned with the base case. Table: 1417P
Population-adjusted relative effects in the base case
Tislelizumab (RATIONALE 302) versus comparator (study) | OS | PFS | TRAE grade ≥3 |
HR (95% CI) | HR (95% CI) | OR (95% CI) | |
Nivolumab (ATTRACTION-3) | 0.88 (0.65, 1.19) | 0.79 (0.59, 1.07) | 1.30 (0.68, 2.48) |
Pembrolizumab (KEYNOTE-181) | 0.94 (0.67, 1.32) | 0.95 (0.63, 1.43) | Not feasible* |
CI, Confidence Interval; HR, Hazard ratio; OR, Odds ratio. *TRAE data was not available for pembrolizumab. DCO=Dec 01, 2020
Conclusions
The STCs showed comparable efficacy and safety between tislelizumab, pembrolizumab, and nivolumab.
Clinical trial identification
NCT03430843.
Editorial acknowledgement
Editorial support, under the direction of the authors, was provided by Smitha Reddy, PhD, of Envision Pharma Inc.
Legal entity responsible for the study
BeiGene, Ltd.
Funding
BeiGene, Ltd.
Disclosure
E.C. Smyth: Financial Interests, Personal, Invited Speaker: Amgen, Bristol Myers Squibb, Imedex, Merck, Novartis, Prova Education, Servier, TouchIME, Elsevier, Peervoice, Cor2Ed, Daiichi Sankyo, MSD, Suzhou Liangihui Network Technology Company Ltd. Financial Interests, Personal, Other, TSC: Amgen; Financial Interests, Personal, Advisory Board: Astellas, AstraZeneca, Bristol Myers Squibb, Bristol Myers Squibb, My Personal Therapeutics, Novartis, Roche, Servier, Zymeworks, Viracta, Boehringer Ingelheim, AbbVie, Natera; Financial Interests, Personal, Other, IDMC: BeiGene, Zymeworks; Financial Interests, Personal, Other, IDMC chair: Everest Clinical Research; Financial Interests, Personal, Other, IDMC Chair: Jazz Pharmaceuticals; Financial Interests, Personal, Officer: EORTC GI Clinical Trials Group; Financial Interests, Institutional, Local PI: Daiichi Sankyo, Merus, Basilea, MSD, Mirati; Financial Interests, Institutional, Coordinating PI: Roche, AstraZeneca, Amgen; Financial Interests, Institutional, Research Grant: Bristol Myers Squibb, AstraZeneca; Non-Financial Interests, Leadership Role, Trustee: UK & Ireland Oesophagogastric Group (UKIOG). J.A. Ajani: Financial Interests, Personal, Advisory Board: BMS, Gilead, Astellas, AZ, Jazz, KirinKyowa, Servier, BeiGene, Daiichi Sankyo; Financial Interests, Institutional, Coordinating PI, My institution receives funding: BMS; Financial Interests, Institutional, Coordinating PI: Merck, Jazz, Astellas, Delta Fly, Gilead, Roche. K. Wang: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks or ownership: BeiGene. J. Coaquira Castro: Financial Interests, Personal, Other, Travel: BeiGene; Financial Interests, Personal, Stocks or ownership: BeiGene, Jazz Pharmaceuticals. M. Figueiredo: Financial Interests, Personal, Speaker, Consultant, Advisor: Pfizer; Financial Interests, Personal, Invited Speaker: Pfizer. K. Soulanis, A. Tasoulas, G. Nikolaidis: Financial Interests, Personal, Full or part-time Employment: IQVIA. E. Priedane: Financial Interests, Personal, Full or part-time Employment: BeiGene. L. Zhan: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks or ownership: BeiGene; Financial Interests, Personal, Other, Travel: BeiGene. All other authors have declared no conflicts of interest.
Resources from the same session
1416P - First-line tislelizumab combined with bevacizumab and CAPOX for metastatic gastroesophageal adenocarcinoma (mGEA) with PD-L1 CPS<5: Updated results of a phase II, prospective, single-arm study
Presenter: guanghai dai
Session: Poster session 17
1418P - Tumor microenvironment B-cell abundance and survival in resectable gastric cancer: A translational analysis from the CLASSIC trial
Presenter: Manavi Sachdeva
Session: Poster session 17
1419P - Osemitamab (TST001) plus nivolumab and CAPOX as the first-line therapy for the patients with advanced G/GEJ cancer (TranStar102)
Presenter: Lin Shen
Session: Poster session 17
1420P - Fibroblast growth factor receptor 2 isoform IIIb (FGFR2b) protein overexpression and biomarker overlap in patients with advanced gastric or gastroesophageal junction cancer (GC/GEJC)
Presenter: Seiya Sato
Session: Poster session 17
1421P - Final results of the phase II trial of HER-Vaxx, a B-cell peptide-based vaccine plus standard care of chemotherapy in patients with HER2-overexpressing advanced gastric cancer - (HERIZON)
Presenter: Joshua Tobias
Session: Poster session 17
1422P - First-line rilvegostomig (rilve) + chemotherapy (CTx) in patients (pts) with HER2-negative (HER2–) locally advanced unresectable or metastatic gastric cancers: First report of GEMINI-Gastric sub study 2
Presenter: Fernando Rivera Herrero
Session: Poster session 17
1423P - Zanidatamab + chemotherapy for first-line (1L) treatment of HER2+ advanced or metastatic gastro-oesophageal adenocarcinoma (mGEA): New and updated data from a phase II trial
Presenter: Elena Elimova
Session: Poster session 17
1424P - Maintenance capecitabine plus ramucirumab after first-line platinum-based chemotherapy in advanced oesophagogastric adenocarcinoma (OGA): Final analysis from the PLATFORM trial
Presenter: Anderley Gordon
Session: Poster session 17
1426P - BL-B01D1, an EGFR x her3 bispecific antibody-drug conjugate (ADC), in patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC)
Presenter: Liu Chang
Session: Poster session 17