Comparison of survival outcomes between dostarlimab and comparator treatments (tx) in patients (pts) with advanced/recurrent (A/R) endometrial cancer (EC) in England: Matching-adjusted indirect comparisons (MAICs).

Authors

null

Scott Goulden

GlaxoSmithKline, London, United Kingdom

Scott Goulden , Kiera Heffernan , Fulya Sen Nikitas , Urmi Shukla , Craig Knott , Matthias Hunger , Ankit Pahwa , Rene Schade

Organizations

GlaxoSmithKline, London, United Kingdom, GlaxoSmithKline (GSK), Middlesex, United Kingdom, GSK, London, United Kingdom, Health Data Insight CIC, Cambridge, United Kingdom, ICON plc, Munich, Germany, ICON plc, Bangalore, India, ICON plc, Reading, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: Limited tx options exist for pts with A/R EC who progress on/after platinum-based chemotherapy (PBCT). This study compared survival outcomes of pts with A/R mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) EC receiving dostarlimab in Cohort A1 of the single-arm, Phase I GARNET trial, with an equivalent real-world (RW) cohort receiving current tx in England. The primary objective compared second-line (2L) overall survival (OS) between cohorts; a secondary objective was time to tx discontinuation (TTD; proxy for progression-free survival). Methods: An overall-2L-tx RW cohort was established using National Cancer Registration and Analysis Service data. Five tx-specific RW cohorts were identified (tx received at 2L in > 5% of pts) (Table). Clinical outcomes between GARNET and RW cohorts were compared using MAICs. Relevant prognostic variables were used to create 3 matching scenarios (SC): SC1: grade, histology, PBCT number; SC2: histology, PBCT number; SC3: race/ethnicity, stage at diagnosis, histology, prior surgery (MMR/MSI status not considered). OS was time from first dostarlimab dose (GARNET) or 2L RW tx (RW cohorts) to any-cause death; MAIC-adjusted hazard ratios (HR, 95% confidence interval [CI]) were estimated by weighted Cox proportional-hazards models. TTD after MAIC was summarized descriptively. Results: Effective sample size (ESS) assessed matching capacity; lower ESS in SC1 reduced its robustness (Table). Following matching, distributions of baseline characteristics were similar between cohorts. Across most matching scenarios, there was a lower risk of death in pts treated with dostarlimab compared to the overall RW cohort and for tx-specific RW cohorts (Table). Median TTD (months, 95% CI) was longer for pts treated with dostarlimab across all matching scenarios (SC1: 7.8 [4.1, not estimable (NE)]; SC2: 9.7 [5.5, NE]; SC3: 14.0 [6.4, 17.9]) than the overall RW cohort (3.4 [3.2, 3.4]). Conclusions: Results suggest that pts in GARNET with dMMR/MSI-H A/R EC receiving dostarlimab had better OS and longer TTD compared with pts receiving current 2L tx in England. Funding: GSK (217216; scott.r.goulden@gsk.com).

HR for OS (dostarlimab vs) (95% CI) [ESS]
SC1
SC2
SC3
Overall
0.52 (0.29, 0.92) [34]*
0.35 (0.22, 0.55) [74]*
0.31 (0.20, 0.49) [75]*
Paclitaxel mono
0.36 (0.19, 0.65) [30]*
0.24 (0.15, 0.40) [72]*
0.18 (0.11, 0.30) [63]*
Carboplatin+paclitaxel
0.70 (0.39, 1.28) [36]
0.48 (0.29, 0.78) [74]*
0.42 (0.25, 0.68) [69]*
Carboplatin+dox
0.74 (0.39, 1.41) [26]
0.45 (0.27, 0.76) [69]*
0.40 (0.24, 0.67) [74]*
Dox mono
0.20 (0.09, 0.44) [37]*
0.17 (0.10, 0.29) [78]*
0.16 (0.09, 0.27) [76]*
Carboplatin mono
0.53 (0.29, 0.98) [23]*
0.32 (0.19, 0.55) [67]*
0.28 (0.16, 0.48) [69]*

Dox, liposomal doxorubicin; mono, monotherapy; *P< 0.05

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Other Gynecologic Cancer

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e17534)

DOI

10.1200/JCO.2022.40.16_suppl.e17534

Abstract #

e17534

Abstract Disclosures