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Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
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现实世界中的费用,治疗模式和与晚期形淋巴瘤激酶阳性非小细胞肺癌治疗相关的临床结果

Rahul Mudumba1, Xiaofan Liu1, Ian Davis1

  • 1Department of Pharmaceutical and Health Economics, Alfred E. Mann School of Pharmacy & Pharmaceutical Sciences, University of Southern California, Los Angeles.

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概括

在ALK阳性非小细胞肺癌 (NSCLC) 中,实验数据显示了第一线 (1L) 亚囊性淋巴瘤激酶 (ALK) 激酶抑制剂 (TKI) 的显著成本和可变结果. 高停药率表明需要仔细选择治疗方法.

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科学领域:

  • 癌症学
  • 药物经济学
  • 现实世界中的证据

背景情况:

  • 根据NCCN的指导方针,alectinib,brigatinib和lorlatinib是首选的一线 (1L) 治疗形淋巴瘤激酶 (ALK) 阳性非小细胞肺癌 (NSCLC) 的疗法.
  • 需要现实世界数据来区分这些疗法超出临床试验,为最佳的治疗选择提供信息.

研究的目的:

  • 评估ALK阳性NSCLC患者接受1LALK氨酸激酶抑制剂 (TKIs) 的实际结果.
  • 专注于药物采购成本,医疗保健利用和临床结果.

主要方法:

  • 使用美国无标识索赔数据 (2016-2021) 的回顾性观察队列研究.
  • 包括18岁以上的ALK+NSCLC患者和至少一个ALK TKI处方填充.
  • 评估了医疗资源的利用率,费用 (PPPM),治疗终止或死亡的时间 (TTD) 和整体存活率 (OS).

主要成果:

  • 在696名患者中,crizotinib是最常见的1L疗法 (n=366),其次是alectinib (n=267).
  • 每个患者每月的总成本为28,216美元;平均30天的供应成本为17,766美元.
  • 平均生存期为25.5个月,平均TTD为8.0个月,只有24.3%的患者转换为二线ALK TKI.

结论:

  • 这项研究强调了ALK阳性晚期NSCLC的经济负担和可变的临床结果.
  • 实际估计为1L治疗序列的成本效益分析和临床决策提供了信息.
  • 高停药率强调了优化初始治疗选择的重要性.