Benchmarking single-arm studies against historical controls from non-small cell lung cancer trials – an empirical analysis of bias

Background: Recent trials of novel agents in ‘rare’ molecular subtypes of non-small cell lung cancer (NSCLC) have used single-arm trial designs and benchmarked outcomes against historical controls. We assessed the consistency of historical control outcomes using docetaxel data from published NSCLC randomized controlled trials (RCTs). Material and methods: Advanced NSCLC RCTs including a docetaxel monotherapy arm were included. Heterogeneity in tumor objective response rates (ORRs), progression-free survival (PFS) and overall survival (OS), and correlations between outcomes and year of trial commencement were assessed. Results: Among 63 trials (N = 10,633) conducted between 2000 and 2017, ORR ranged from 0% to 26% (I2 = 76.1%, pheterogeneity < .0001). Mean of the median PFS was 3.0 months (range: 1.4–6.4), 3-month PFS ranged from 25% to 85% (I2 = 86.0%, pheterogeneity < .0001). Mean of the median OS was 9.1 months (range: 4.7–22.9), 9-month OS ranged from 23% to 79% (I2 = 83.0%, pheterogeneity < .0001). Each later year of trial commencement was associated with 0.3% (p = .046), 0.5% (p = .11) and 0.9% (p = .001) improvement in ORR, 3-month PFS and 9-month OS rates, respectively. Conclusions: There was significant heterogeneity and an improving trend in docetaxel outcomes across trials conducted over 20 years. Benchmarking biomarker-targeted agents against historical controls may not be a valid approach to replace RCTs. Innovative study designs involving a concurrent control arm should be considered.

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PID https://www.doi.org/10.6084/m9.figshare.9976415.v1
PID https://www.doi.org/10.6084/m9.figshare.9976415
URL http://dx.doi.org/10.6084/m9.figshare.9976415.v1
URL https://figshare.com/articles/Benchmarking_single-arm_studies_against_historical_controls_from_non-small_cell_lung_cancer_trials_an_empirical_analysis_of_bias/9976415
URL https://dx.doi.org/10.6084/m9.figshare.9976415.v1
URL http://dx.doi.org/10.6084/m9.figshare.9976415
URL https://dx.doi.org/10.6084/m9.figshare.9976415
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Author Snyders, Kelli
Author Doah Cho
Author Hong, Jun Hee
Author Sally Lord
Author Asher, Rebecca
Author Marschner, Ian
Author Lee, Chee Khoon
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Collected From Datacite; figshare
Hosted By figshare
Publication Date 2019-10-14
Publisher Taylor & Francis
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keyword FOS: Health sciences
system:type dataset
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Source https://science-innovation-policy.openaire.eu/search/dataset?datasetId=dedup_wf_001::39b45f9317c10ef3a5d78c8b922d4e22
Author jsonws_user
Last Updated 16 December 2020, 01:48 (CET)
Created 16 December 2020, 01:48 (CET)