TABLE 34Summary of the clinical effectiveness parameter estimates used in the PenTAG AR2 model

ParameterEstimate, PenTAG AR2 (SHTAC)SourceaJustification
MCyR rate: dasatinib58.1% (59%)Shah et al. (2008)aOnly available estimate at currently recommended dose of dasatinib
MCyR rate: nilotinib52.4% (56%)Kantarjian et al. (2007)6Only available estimate
MCyR rate: HDI44.0% (54%)Jabbour et al. (2009)23Estimates of OS, PFS and MCyR rate all originate from the same study
MCyR rate: IFN-α22%O'Brien et al. (2003)bMost recent large trial of IFN-α
Proportion of patients who discontinue dasatinib prematurely10.2%Shah et al. (2008)aTreatment discontinuations are included in PFS
Proportion of patients who discontinue nilotinib prematurely23.2%Kantarjian et al. (2007)6Only available estimated
Proportion of patients who discontinue HDI prematurely14.8%Pooled estimatePooled from all available data
Overall survival hazard ratio between people who achieve a MCyR to imatinib and those who do not0.370Pooled estimatePooling all data sources reduces the uncertainty in the data
Mean time spent in AP0.80 yearsReed et al. (2004)19 and Cervantes et al. (1996)cLarge, relevant data source
Mean time spent in BC1.09 yearsReed et al. (2004)19 and Kantarjian et al. (2001)dLarge, relevant data source

AP, accelerated phase; BC, blast crisis; HDI, high-dose imatinib; IFN-α, interferon alfa; MCyR, major cytogenetic response; OS, overall survival; PFS, progression-free survival.

a

Shah et al. J Clin Oncol 2008;26:320–12.

b

O'Brien et al. N Engl J Med 2003;348:994–1004.

c

Cervantes et al. Eur J Haematol 1996;57:286–91.

d

Kantarjian et al. Cancer 2001;92:250–7.

MCyR typically defined as ≤ 35% Philadelphia-positive chromosomes in metaphase in bone marrow (study definitions may vary).

From: 4, Economic analysis

Cover of Dasatinib, High-Dose Imatinib and Nilotinib for the Treatment of Imatinib-Resistant Chronic Myeloid Leukaemia: A Systematic Review and Economic Evaluation
Dasatinib, High-Dose Imatinib and Nilotinib for the Treatment of Imatinib-Resistant Chronic Myeloid Leukaemia: A Systematic Review and Economic Evaluation.
Health Technology Assessment, No. 16.23.
Loveman E, Cooper K, Bryant J, et al.
Southampton (UK): NIHR Journals Library; 2012 May.
© 2012, Crown Copyright.

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