Oncology Simulation Model: A Comprehensive and Innovative Approach to Estimate and Project Prevalence and Survival in Oncology

Abstract

Objective

We demonstrate a new model framework as an innovative approach to more accurately estimate and project prevalence and survival outcomes in oncology.

Methods

We developed an oncology simulation model (OSM) framework that offers a customizable, dynamic simulation model to generate population-level, country-specific estimates of prevalence, incidence of patients progressing from earlier stages (progression-based incidence), and survival in oncology. The framework, a continuous dynamic Markov cohort model, was implemented in Microsoft Excel. The simulation runs continuously through a prespecified calendar time range. Time-varying incidence, treatment patterns, treatment rates, and treatment pathways are specified by year to account for guideline-directed changes in standard of care and real-world trends, as well as newly approved clinical treatments. Patient cohorts transition between defined health states, with transitions informed by progression-free survival and overall survival as reported in published literature.

Results

Model outputs include point prevalence and period prevalence, with options for highly granular prevalence predictions by disease stage, treatment pathway, or time of diagnosis. As a use case, we leveraged the OSM framework to estimate the prevalence of bladder cancer in the United States.

Conclusion

The OSM is a robust model that builds upon existing modeling practices to offer an innovative, transparent approach in estimating prevalence, progression-based incidence, and survival for oncologic conditions. The OSM combines and extends the capabilities of other common health-economic modeling approaches to provide a detailed and comprehensive modeling framework to estimate prevalence in oncology using simulation modeling and to assess the impacts of new treatments on prevalence over time.

Keywords:

• epidemiology
• Markov
• modeling
• oncology
• OSM
• prevalence

Abbreviations

1L/2L/3L, first-/second-/third-line; APC, age-period-cohort; BC, bladder cancer; BCG, bacillus Calmette-Guérin; CCRT, concurrent chemoradiation therapy; KOL, key opinion leader; la/mUC, locally advanced or metastatic urothelial carcinoma; MIAMOD, Mortality and Incidence Analysis MODel; MIBC, muscle-invasive bladder cancer; NMIBC, non-muscle-invasive bladder cancer; OS, overall survival; OSM, oncology simulation model; PD, progressed disease; PFS, progression-free survival; PIAMOD, Prevalence and Incidence Analysis MODel; SEER, Surveillance, Epidemiology, and End Results; TURBT, transurethral resection of the bladder tumor; UC, urothelial cancer; US, United States.

Data Sharing Statement

This analysis is based on previously published data.

Ethics Approval and Informed Consent

This analysis is based on published data and ethical approval was not required.

Acknowledgments

Medical writing support was provided by Philip Ruane of Curo Consulting, a division of Envision Pharma Group, and funded by Seagen Inc.

Author Contributions

All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

BB, JT, and LB are employees of Curta Inc., paid consultants to Seagen Inc. in connection with this study. HSW and ZH are employees and stockholders of Seagen Inc. HSW is also stockholder of Amgen Inc. and Teva Pharmaceuticals. CM is an employee and stockholder of Astellas, Inc. and also a stockholder of Merck and J&J. MDG has served as an advisory board member and consultant for Aileron Therapeutics, Astellas, AstraZeneca, Basiliea, BioMotiv, BMS, Dendreon, Dracen, Dragonfly, EMD Serono, Genentech, GSK, Incyte, Inovio Pharmaceuticals, Janssen, Lilly, Merck, Novartis, Numab, Pfizer, Seagen Inc., and Urogen; has equity ownership in Rappta Therapeutics; holds patents/royalties for “Methods and compositions for treating cancer and related methods (20120322792)”; and has received research funding from AstraZeneca, BMS, Dendreon, Genentech, Janssen, Merck, and Novartis.

Additional information

Funding

This work was supported by funding from Seagen Inc. and Astellas, Inc.