Comparative Effectiveness Analysis Using Real World Evidence (RWE) and Applying a Causal Marginal Structural Model: the Case of Second-Line Treatment in Patients with Ovarian Cancer
Aim: To investigate the comparative effectiveness of trastuzumab emtansine (T-DM1) in a real-world population of HER2+ metastatic breast cancer (mBC) patients. Materials and methods: The Flatiron Health database was used to identify a cohort of HER2+ mBC patients who received first-line trastuzumab treatment and T-DM1 or lapatinib plus capecitabine as second-line treatment. Overall survival was compared between the two groups. Results: Three hundred and forty-five patients with HER2+ mBC received second-line T-DM1 and 65 lapatinib plus capecitabine. Overall survival was longer in patients treated with T-DM1 than those treated with lapatinib plus capecitabine (adjusted hazard ratio: 0.61; 95% CI: 0.41–0.91). Conclusion: Real-world data supports the effectiveness of T-DM1 in the second-line treatment of HER2+ mBC patients.