Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons
In Philadelphia chromosome-positive B-cell (Ph+) acute lymphoblastic leukemia (LLA), growing evidence has accumulated regarding the efficacy of low-intensity and chemo-free regimens. Our objective was to analyze all recent trials evaluating these treatments and to compare them in terms of efficacy....
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Hematology Reports |
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| Online Access: | https://www.mdpi.com/2038-8330/15/4/68 |
| _version_ | 1797380872764129280 |
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| author | Melania Rivano Daniele Mengato Marco Chiumente Andrea Messori |
| author_facet | Melania Rivano Daniele Mengato Marco Chiumente Andrea Messori |
| author_sort | Melania Rivano |
| collection | DOAJ |
| description | In Philadelphia chromosome-positive B-cell (Ph+) acute lymphoblastic leukemia (LLA), growing evidence has accumulated regarding the efficacy of low-intensity and chemo-free regimens. Our objective was to analyze all recent trials evaluating these treatments and to compare them in terms of efficacy. We applied the Shiny method, an artificial intelligence technique, to analyze Kaplan–Meier curves and reconstruct patient-level data. Reconstructed patient data were then evaluated through standard survival statistics and subjected to indirect head-to-head treatment comparisons. The endpoint was progression-free survival (PFS). Based on 432 reconstructed patients, eight trials were analyzed. The survival data from these trials were pooled into three types of treatments: (i) treatments based on tyrosine kinase inhibitors (TKIs) combined with reduced-intensity chemotherapy (denoted as TKICHE); (ii) TKIs associated with steroids with no chemotherapy (TKISTE); (iii) chemotherapy-free combinations of blinatumomab plus TKIs (TKIBLI). According to the Shiny method, the three PFS curves were reported in a single Kaplan–Meier graph and subjected to survival statistics. In terms of PFS, TKIBLI ranked first, TKICHE second, and TKISTE third; the differences between these three regimens were statistically significant. This multi-treatment Kaplan–Meier graph, generated through the Shiny method, summarized the current evidence on these treatments in both qualitative and quantitative terms. |
| first_indexed | 2024-03-08T20:44:15Z |
| format | Article |
| id | doaj.art-e4c8fbb9e9a8485a828999abc21d3b44 |
| institution | Directory Open Access Journal |
| issn | 2038-8330 |
| language | English |
| last_indexed | 2024-03-08T20:44:15Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj.art-e4c8fbb9e9a8485a828999abc21d3b442023-12-22T14:12:12ZengMDPI AGHematology Reports2038-83302023-11-0115467068310.3390/hematolrep15040068Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect ComparisonsMelania Rivano0Daniele Mengato1Marco Chiumente2Andrea Messori3Binaghi Hospital, 09126 Cagliari, ItalyHospital Pharmacy Department, Azienda Ospedale—Università of Padova, Via Giustiniani 2, 35128 Padua, ItalyScientific Direction, Società Italiana di Farmacia Clinica e Terapia (SIFaCT), 10123 Torino, ItalyHTA Unit, Regional Health Care System, Regione Toscana, 50139 Firenze, ItalyIn Philadelphia chromosome-positive B-cell (Ph+) acute lymphoblastic leukemia (LLA), growing evidence has accumulated regarding the efficacy of low-intensity and chemo-free regimens. Our objective was to analyze all recent trials evaluating these treatments and to compare them in terms of efficacy. We applied the Shiny method, an artificial intelligence technique, to analyze Kaplan–Meier curves and reconstruct patient-level data. Reconstructed patient data were then evaluated through standard survival statistics and subjected to indirect head-to-head treatment comparisons. The endpoint was progression-free survival (PFS). Based on 432 reconstructed patients, eight trials were analyzed. The survival data from these trials were pooled into three types of treatments: (i) treatments based on tyrosine kinase inhibitors (TKIs) combined with reduced-intensity chemotherapy (denoted as TKICHE); (ii) TKIs associated with steroids with no chemotherapy (TKISTE); (iii) chemotherapy-free combinations of blinatumomab plus TKIs (TKIBLI). According to the Shiny method, the three PFS curves were reported in a single Kaplan–Meier graph and subjected to survival statistics. In terms of PFS, TKIBLI ranked first, TKICHE second, and TKISTE third; the differences between these three regimens were statistically significant. This multi-treatment Kaplan–Meier graph, generated through the Shiny method, summarized the current evidence on these treatments in both qualitative and quantitative terms.https://www.mdpi.com/2038-8330/15/4/68acute lymphoblastic leukemiaimatinibdasatinib: nilotinibponatinibblinatumomabreduced-intensity chemotherapy |
| spellingShingle | Melania Rivano Daniele Mengato Marco Chiumente Andrea Messori Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons Hematology Reports acute lymphoblastic leukemia imatinib dasatinib: nilotinib ponatinib blinatumomab reduced-intensity chemotherapy |
| title | Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons |
| title_full | Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons |
| title_fullStr | Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons |
| title_full_unstemmed | Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons |
| title_short | Low-Intensity and Chemo-Free Treatments in Ph+ ALL: Progression-Free Survival Based on Indirect Comparisons |
| title_sort | low intensity and chemo free treatments in ph all progression free survival based on indirect comparisons |
| topic | acute lymphoblastic leukemia imatinib dasatinib: nilotinib ponatinib blinatumomab reduced-intensity chemotherapy |
| url | https://www.mdpi.com/2038-8330/15/4/68 |
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