基于免疫检查点抑制剂的第一线疗法,用于晚期或不可切除的肝细胞癌:网络元分析和成本效益分析
Huijie Qi1, Yuxin Huang1, Wenxin Zhang1
1Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China.
Therapeutic advances in medical oncology
|March 10, 2026
概括
免疫检查点抑制剂 (ICI) 疗法在晚期肝细胞癌 (HCC) 中表现有前途. 在中国,camrelizumab加rivoceranib具有成本效益,但在美国,目前的ICI选择对HCC来说不具有成本效益.
科学领域:
- 在瘤学瘤学.
- 药物经济学 药物经济学
- 卫生政策 卫生政策
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了晚期肝细胞癌 (HCC) 治疗.
- 基于ICI的组合的比较临床疗效和成本效益需要澄清.
研究的目的:
- 评估12种基于ICI的第一线治疗先进HCC的成本效益和临床疗效.
- 将这些疗法与中国和美国医疗保健系统进行比较.
主要方法:
- 网络元分析 (NMA) 总生存率 (OS) 和无进展生存率 (PFS).
- 划分生存模型用于成本效益分析,计算质量调整寿命年 (QALY) 和增量成本效益比率 (ICER).
- 敏感性分析用于评估模型不确定性.
主要成果:
- 11项试验的NMA (7289名患者) 显示,四种ICI疗法改善了OS和PFS,而不是 sorafenib.
- 在中国,camrelizumab加上rivoceranib和tislelizumab是具有成本效益的.
- 在美国,没有ICI治疗达到15万美元/QALY的门;索拉费尼布仍然是最具成本效益的.
结论:
- 卡姆雷利祖马布加上利沃赛拉尼布是中国高级HCC的成本效益高的第一线选择.
- 目前的ICI疗法在美国以现有的价格是不具有成本效益的.
- 调查结果为不同医疗机构的治疗选择和健康政策提供了信息.
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