Bayesian hierarchical model-based network meta-analysis to overcome survival extrapolation challenges caused by data immaturity

Bart Heeg, Andre Verhoek, Gabriel Tremblay, Ofir Harari, Mohsen Soltanifar, Haitao Chu, Satrajit Roychoudhury, Joseph C. Cappelleri

Research output: Contribution to journalArticlepeer-review


Aim: This research evaluated standard Weibull mixture cure (WMC) network meta-analysis (NMA) with Bayesian hierarchical (BH) WMC NMA to inform long-term survival of therapies. Materials & methods: Four trials in previously treated metastatic non-small-cell lung cancer with PD-L1 >1% were used comparing docetaxel with nivolumab, pembrolizumab and atezolizumab. Cure parameters related to a certain treatment class were assumed to share a common distribution. Results: Standard WMC NMA predicted cure rates were 0.03 (0.01; 0.07), 0.18 (0.12; 0.24), 0.07 (0.02; 0.15) and 0.03 (0.00; 0.09) for docetaxel, nivolumab, pembrolizumab and atezolizumab, respectively, with corresponding incremental life years (LY) of 3.11 (1.65; 4.66), 1.06 (0.41; 2.37) and 0.42 (-0.57; 1.68). The Bayesian hierarchical-WMC-NMA rates were 0.06 (0.03; 0.10), 0.17 (0.11; 0.23), 0.12 (0.05; 0.20) and 0.12 (0.03; 0.23), respectively, with incremental LY of 2.35 (1.04; 3.93), 1.67 (0.68; 2.96) and 1.36 (-0.05; 3.64). Conclusion: BH-WMC-NMA impacts incremental mean LYs and cost–effectiveness ratios, potentially affecting reimbursement decisions. Tweetable abstract: Bayesian hierarchical model-based network meta-analysis for survival outcomes are shown to overcome data immaturity issues in the evidence network, impact incremental mean life years and cost–effectiveness ratios, affecting reimbursement decisions.

Original languageEnglish (US)
Article numbere220159
JournalJournal of Comparative Effectiveness Research
Issue number3
StatePublished - Mar 2023

Bibliographical note

Publisher Copyright:
© 2023 Cytel.


  • bayesian hierarchical modelling
  • immunotherapies
  • indirect treatment comparisons
  • mixture cure
  • network meta-analysis
  • oncology
  • survival extrapolation

PubMed: MeSH publication types

  • Meta-Analysis
  • Journal Article


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