Real-World Evidence and Meta-Analysis of Chemoimmunotherapy Utilization

The discussion moves to real-world evidence and meta-analysis. The faculty first review a meta-analysis that pooled randomized trials with retrospective real-world cohorts and evaluated whether adding durvalumab or pembrolizumab to gemcitabine and cisplatin improves outcomes relative to chemotherapy alone. They then review LIVER-R, a global, multicountry study collecting data on durvalumab-based therapy in routine practice, with real-world overall survival and real-world progression-free survival among the outcomes assessed. The faculty note that the dataset remains immature and that longer follow-up is needed. The faculty then proceed to review United States claims data comparing durvalumab plus gemcitabine and cisplatin with chemotherapy alone. Afterwards, the faculty discuss why real-world survival estimates may trend higher than trial estimates.