Cost–effectiveness of second-line nivolumab for platinum-treated advanced non-small-cell lung cancer

2020 ◽  
Vol 9 (18) ◽  
pp. 1301-1309
Author(s):  
Longfeng Zhang ◽  
Xiaofang Zeng ◽  
Hongfu Cai ◽  
Na Li ◽  
Maobai Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cost Effectiveness ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Phase Iii ◽  
Second Line ◽  
Small Cell Lung ◽  
The Cost ◽  
Quality Adjusted Life

Aim: To analyze the economic impact of nivolumab and chemotherapy in patients with non-small-cell lung cancer (NSCLC) who developed disease progression after platinum-containing dual-drug chemotherapy. Materials & methods: The partitioned survival model was used to analyze the cost-utility of two NSCLC treatments by nivolumab and docetaxel. The clinical data resulted from the Phase III clinical trial. The cost parameters were derived from our previous studies, and the utility parameters were derived from the literature. Results: The quality-adjusted life-years of nivolumab and docetaxel were 0.778 and 0.336. The lifetime direct medical expenses of nivolumab and docetaxel were US$44,707.17 and US$12,826.72. The incremental cost–effectiveness ratio was $72,127.71/quality-adjusted life-year. Conclusion: The combination of chemotherapy, nivolumab is not a cost-effective choice in the second-line treatment of NSCLC.

scholarly journals The Cost-Effectiveness of Second-Line Crizotinib in Eml4-Alk Rearranged Advanced Non-Small Cell Lung Cancer

2014 ◽  
Vol 17 (7) ◽  
pp. A642 ◽  
Author(s):  
S. Djalalov ◽  
D.M. Graham ◽  
J. Beca ◽  
J.S. Hoch ◽  
M.S. Tsao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cost Effectiveness ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
The Cost

scholarly journals Cost-Effectiveness In The Second-Line Treatment Of Non-Small Cell Lung Cancer (Nsclc) In The Us

2015 ◽  
Vol 18 (7) ◽  
pp. A457-A458 ◽  
Author(s):  
C Graham ◽  
H Knox ◽  
LM Hess ◽  
M Jen ◽  
G Cuyun Carter ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cost Effectiveness ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Line Treatment ◽  
Second Line ◽  
Small Cell Lung ◽  
The Us

Economic Analysis of the TAX 317 Trial: Docetaxel Versus Best Supportive Care as Second-Line Therapy of Advanced Non–Small-Cell Lung Cancer

2002 ◽  
Vol 20 (5) ◽  
pp. 1344-1352 ◽  
Author(s):  
Natasha B. Leighl ◽  
Frances A. Shepherd ◽  
Rita Kwong ◽  
Ronald L. Burkes ◽  
Ronald Feld ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Supportive Care ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Best Supportive Care ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
The Cost

PURPOSE: To determine the cost-effectiveness (CE) of second-line docetaxel compared with best supportive care (BSC) in the TAX 317 trial, a randomized clinical trial of second-line chemotherapy in non–small-cell lung cancer. METHODS: A retrospective CE analysis of the TAX 317 trial was undertaken, evaluating direct medical costs of therapy from the viewpoint of Canada’s public health care system. Costs were derived in 1999 Canadian dollars, and resource use was determined through prospective trial data. RESULTS: The incremental survival benefit in the docetaxel arm over BSC was 2 months (P = .047). The CE of docetaxel was $57,749 per year of life gained. For patients treated with docetaxel 75 mg/m2, the CE was $31,776 per year of life gained. In univariate sensitivity analyses, CE estimates were most sensitive to changes in survival, ranging from $18,374 to $117,434 with 20% variation in survival at the recommended dose. The largest cost center in both arms was hospitalization, followed by the cost of drugs, investigations, radiotherapy, and community care. BSC patients had fewer hospitalizations than patients in the chemotherapy arm and were more often palliated at home. CONCLUSION: Although the decision to treat should not be based on economic considerations alone, our CE estimate of $31,776 per year of life gained (at the currently recommended dose of docetaxel) is within an acceptable range of health care expenditures, and the total costs of therapy are similar to those of second-line palliative chemotherapy for other solid tumors.

Randomized Phase III Trial of Pemetrexed Versus Docetaxel in Patients With Non–Small-Cell Lung Cancer Previously Treated With Chemotherapy

2004 ◽  
Vol 22 (9) ◽  
pp. 1589-1597 ◽  
Author(s):  
Nasser Hanna ◽  
Frances A. Shepherd ◽  
Frank V. Fossella ◽  
Jose R. Pereira ◽  
Filippo De Marinis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Performance Status ◽  
Small Cell ◽  
Phase Iii ◽  
Second Line ◽  
Small Cell Lung ◽  
Previously Treated

Purpose To compare the efficacy and toxicity of pemetrexed versus docetaxel in patients with advanced non—small-cell lung cancer (NSCLC) previously treated with chemotherapy. Patients and Methods Eligible patients had a performance status 0 to 2, previous treatment with one prior chemotherapy regimen for advanced NSCLC, and adequate organ function. Patients received pemetrexed 500 mg/m2 intravenously (IV) day 1 with vitamin B12, folic acid, and dexamethasone or docetaxel 75 mg/m2 IV day 1 with dexamethasone every 21 days. The primary end point was overall survival. Results Five hundred seventy-one patients were randomly assigned. Overall response rates were 9.1% and 8.8% (analysis of variance P = .105) for pemetrexed and docetaxel, respectively. Median progression-free survival was 2.9 months for each arm, and median survival time was 8.3 versus 7.9 months (P = not significant) for pemetrexed and docetaxel, respectively. The 1-year survival rate for each arm was 29.7%. Patients receiving docetaxel were more likely to have grade 3 or 4 neutropenia (40.2% v 5.3%; P < .001), febrile neutropenia (12.7% v 1.9%; P < .001), neutropenia with infections (3.3% v 0.0%; P = .004), hospitalizations for neutropenic fever (13.4% v 1.5%; P < .001), hospitalizations due to other drug related adverse events (10.5% v 6.4%; P = .092), use of granulocyte colony-stimulating factor support (19.2% v 2.6%, P < .001) and all grade alopecia (37.7% v 6.4%; P < .001) compared with patients receiving pemetrexed. Conclusion Treatment with pemetrexed resulted in clinically equivalent efficacy outcomes, but with significantly fewer side effects compared with docetaxel in the second-line treatment of patients with advanced NSCLC and should be considered a standard treatment option for second-line NSCLC when available.

Phase III Study of Second-Line Chemotherapy for Advanced Non–Small-Cell Lung Cancer With Weekly Compared With 3-Weekly Docetaxel

2005 ◽  
Vol 23 (33) ◽  
pp. 8389-8395 ◽  
Author(s):  
Wolfgang Schuette ◽  
Sylke Nagel ◽  
Thomas Blankenburg ◽  
Christine Lautenschlaeger ◽  
Klaus Hans ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Phase Iii ◽  
Second Line ◽  
Small Cell Lung ◽  
Weekly Docetaxel ◽  
Phase Iii Study ◽  
Grade 3

Purpose A phase III study to determine whether a weekly docetaxel schedule improves the therapeutic index compared with the classic 3-weekly schedule. Patients and Methods Patients with stage IIIB-IV non–small-cell lung cancer (NSCLC) were randomly assigned to docetaxel 75 mg/m2 on day 1 every 3 weeks (3-weekly) and 35 mg/m2 on days 1, 8, and 15 (weekly) for ≤ eight cycles. End points included survival (primary), toxicity, and response. Results Of 215 patients enrolled, 208 (103 in the 3-weekly arm and 105 in the weekly arm) were assessable for response. At baseline, 24.5% of patients (51 out of 208) had received prior paclitaxel therapy and 43.3% of patients (90 out of 208) had been progression-free for more than 3 months after first-line therapy. After 12 months' follow-up, median survival was 6.3 months (95% CI, 4.68 to 7.84 months) with 3-weekly docetaxel and 9.2 months (95% CI, 5.83 to 12.59 months) with weekly docetaxel (P = .07) after a median of four (range, one to eight) and two (range, one to eight) treatment cycles, respectively. Overall, response rates were 12.6% v 10.5% with 3-weekly versus weekly docetaxel. Significantly fewer patients reported grade 3 to 4 toxicities with weekly docetaxel versus 3-weekly docetaxel (P ≤ .05). There were significantly lower rates of grade 3 to 4 anemia (P ≤ .05), leucopenia (P < .0001), and neutropenia (P ≤ .001) with weekly versus 3-weekly treatment. No grade 3 to 4 thrombocytopenia or mucositis was reported. Conclusion Weekly docetaxel 35 mg/m2 demonstrated similar efficacy and better tolerability than standard 3-weekly docetaxel 75 mg/m2 and can be recommended as a feasible alternative second-line treatment option for patients with advanced NSCLC.

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