Matching adjusted indirect comparison (MAIC) of [177Lu]Lu-DOTA-TATE (177Lu-DOTATATE) vs. streptozocin-based chemotherapies (STZ-BC) as first-line (1L) treatment for advanced grade 2/3 (G2/G3) pancreatic NETs (pNETs)

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Introduction: The NETTER-2 trial showed improved progression-free survival (PFS) with 1L 177Lu-DOTATATE vs. high dose octreotide in advanced G2/G3 pNETs. No published evidence exists comparing 177Lu-DOTATATE with other recommended 1L treatments, such as STZ-BC, hence indirect comparisons need to be conducted.

Aim(s): To assess the relative efficacy of 177Lu-DOTATATE vs. STZ-BC as 1L treatment for patients with advanced G2/G3 pNETs using MAIC.

Materials and methods: In the absence of randomised trials, two retrospective studies, Apostolidis 2021, which assessed STZ+5-fluorouracil (5-FU) in patients with advanced G3 pNETs, and Roquin 2017, which assessed STZ-BC (STZ plus doxorubicin, 5-FU, or others) in patients with advanced G2/G3 pNETs, were considered suitable for the analysis. Study selection was based on the eligibility criteria for the MAIC including adequate sample size, availability of baseline characteristics, and Kaplan Meier curve for PFS. Unanchored pairwise MAICs for PFS were conducted using individual patient data from NETTER-2 and aggregated data from these respective studies. Multiple scenarios with different combinations of covariates used in the MAIC weighting were considered with the final model selected to maintain adequate effective sample size (ESS).

Conference:

Presenting Author: Navalkissoor S

Authors: Navalkissoor S, Capdevila J, Deshayes E, Gerard L, Srirajaskanthan R,

Keywords: pancreatic neuroendocrine tumour, [177lu]lu-dotatate, streptozocin, 5-fluorouracil, matching adjusted indirect comparison,