No study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data.
AffiliationOxford Outcomes Ltd., Oxford, UK. firstname.lastname@example.org
MetadataShow full item record
AbstractOBJECTIVE: To demonstrate the importance of considering all relevant indirect data in a network meta-analysis of treatments for non-small-cell lung cancer (NSCLC). METHODS: A recent National Institute for Health and Clinical Excellence appraisal focussed on the indirect comparison of docetaxel with erlotinib in second-line treatment of NSCLC based on trials including a common comparator. We compared the results of this analysis to a network meta-analysis including other trials that formed a network of evidence. We also examined the importance of allowing for the correlations between the estimated treatment effects that can arise when analysing such networks. RESULTS: The analysis of the restricted network including only trials of docetaxel and erlotinib linked via the common placebo comparator produced an estimated mean hazard ratio (HR) for erlotinib compared with docetaxel of 1.55 (95% confidence interval [CI] 0.72-2.97). In contrast, the network meta-analysis produced an estimated HR for erlotinib compared with docetaxel of 0.83 (95% CI 0.65-1.06). Analyzing the wider network improved the precision of estimated treatment effects, altered their rankings and also allowed further treatments to be compared. Some of the estimated treatment effects from the wider network were highly correlated. CONCLUSIONS: This empirical example shows the importance of considering all potentially relevant data when comparing treatments. Care should therefore be taken to consider all relevant information, including correlations induced by the network of trial data, when comparing treatments.
CitationNo study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data. 2009, 12 (6):996-1003 Value Health
JournalValue in Health
- Erlotinib or docetaxel for second-line treatment of non-small cell lung cancer: a real-world cost-effectiveness analysis.
- Authors: Cromwell I, van der Hoek K, Melosky B, Peacock S
- Issue date: 2011 Dec
- Randomized phase III trial of erlotinib versus docetaxel as second- or third-line therapy in patients with advanced non-small-cell lung cancer: Docetaxel and Erlotinib Lung Cancer Trial (DELTA).
- Authors: Kawaguchi T, Ando M, Asami K, Okano Y, Fukuda M, Nakagawa H, Ibata H, Kozuki T, Endo T, Tamura A, Kamimura M, Sakamoto K, Yoshimi M, Soejima Y, Tomizawa Y, Isa S, Takada M, Saka H, Kubo A
- Issue date: 2014 Jun 20
- Erlotinib for the treatment of relapsed non-small cell lung cancer.
- Authors: McLeod C, Bagust A, Boland A, Hockenhull J, Dundar Y, Proudlove C, Davis H, Green J, Macbeth F, Stevenson J, Walley T, Dickson R
- Issue date: 2009 Jun
- Efficacy and safety of erlotinib versus chemotherapy in second-line treatment of patients with advanced, non-small-cell lung cancer with poor prognosis (TITAN): a randomised multicentre, open-label, phase 3 study.
- Authors: Ciuleanu T, Stelmakh L, Cicenas S, Miliauskas S, Grigorescu AC, Hillenbach C, Johannsdottir HK, Klughammer B, Gonzalez EE
- Issue date: 2012 Mar
- Efficacy of erlotinib in patients with advanced non-small cell lung cancer: a pooled analysis of randomized trials.
- Authors: Gao H, Ding X, Wei D, Cheng P, Su X, Liu H, Aziz F, Wang D, Zhang T
- Issue date: 2011 Oct