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免疫疗法加化疗在晚期子宫内膜癌患者:一个成本效益分析

Youwen Zhu¹, Kun Liu¹, Hong Zhu^1,2

¹Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.

Journal of gynecologic oncology

|June 10, 2024

概括

对于晚期子宫内膜癌 (EC),多斯塔利马布加化学疗法比布罗利祖马布加化学疗法更具成本效益. 与单独的化疗相比,Dostarlimab在不匹配修复缺陷,微卫星不稳定性高 (dMMR-MSI-H) EC中提供了更好的价值.

科学领域:

在瘤学瘤学.
卫生经济学卫生经济学
药物经济学药物经济学

背景情况:

晚期子宫内膜癌 (EC) 治疗受益于组合抗编程死亡受体1 (PD-1) 疗法.
免疫检查点抑制剂如pembrolizumab和 dostarlimab针对PD-1,提供新的治疗途径.
对成本效益的比较对于确定高级EC的最佳治疗策略至关重要.

研究的目的:

为了评估德拉利马布加化疗 (DC),布罗利祖马布加化疗 (PC) 和单独化疗 (C) 的成本效益,用于高级EC.
为了比较这些治疗选择的患者不匹配修复熟练的微卫星稳定 (pMMR-MSS) 和不匹配修复不足的微卫星不稳定性高 (dMMR-MSI-H) 疾病.
从美国纳税人的角度来看,确定最经济可行的治疗方法.

主要方法:

使用了具有20年时间视界的马尔科夫模型.
从RUBY和NRG-GY018III期随机对照试验中获得的患者和临床数据被纳入.
用总成本,寿命年 (LY),质量调整寿命年 (QALY) 和增量成本效益比率 (ICER) 来评估成本效益.

主要成果:

在pMMR-MSS EC中,DC产生的ICER为$86,671/QALY与PC相比,和$234,527/QALY与单独的化疗相比.
在dMMR-MSI-H EC中,DC与PC相比显示出一个非常有利的ICER7,866美元/QALY.
在dMMR-MSI-H群体中,DC也比单独的化疗更具成本效益 (135,165美元/QALY).

结论:

对于晚期子宫内膜癌,多斯塔利马布加化疗 (DC) 是比布罗利祖马布加化疗 (PC) 更具成本效益的治疗选择,无论不匹配修复 (MMR) 状态如何.
与单独化疗相比,DC显示出显著的成本效益优势,特别是在dMMR-MSI-H高级EC群体中.
这些发现支持DC作为美国从健康经济的角度来看的首选治疗策略.

关键词:

组合化疗是一种化学疗法.成本效益分析成本效益分析宫内膜癌宫内膜癌是什么?免疫检查点抑制剂免疫检查点抑制剂纠正不匹配的修复方法

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