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Cost-Effectiveness Analysis of Biomarker-Guided Treatment for Metastatic Gastric Cancer in the Second-Line Setting
المؤلفون المشاركون
Lauren, Brianna
Ostvar, Sassan
Silver, Elisabeth
Ingram, Myles
Oh, Aaron
Kumble, Lindsay
Laszkowska, Monika
Chu, Jacqueline N.
Hershman, Dawn L.
Manji, Gulam
Hur, Chin
Neugut, Alfred
المصدر
العدد
المجلد 2020، العدد 2020 (31 ديسمبر/كانون الأول 2020)، ص ص. 1-10، 10ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2020-02-17
دولة النشر
مصر
عدد الصفحات
10
التخصصات الرئيسية
الملخص EN
Background.
The 5-year survival rate of patients with metastatic gastric cancer (GC) is only 5%.
However, trials have demonstrated promising antitumor activity for targeted therapies/immunotherapies among chemorefractory metastatic GC patients.
Pembrolizumab has shown particular efficacy among patients with programmed death ligand-1 (PD-L1) expression and high microsatellite instability (MSI-H).
The aim of this study was to assess the effectiveness and cost-effectiveness of biomarker-guided second-line GC treatment.
Methods.
We constructed a Markov decision-analytic model using clinical trial data.
Our model compared pembrolizumab monotherapy and ramucirumab/paclitaxel combination therapy for all patients and pembrolizumab for patients based on MSI status or PD-L1 expression.
Paclitaxel monotherapy and best supportive care for all patients were additional comparators.
Costs of drugs, treatment administration, follow-up, and management of adverse events were estimated from a US payer perspective.
The primary outcomes were quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) with a willingness-to-pay threshold of $100,000/QALY over 60 months.
Secondary outcomes were unadjusted life years (survival) and costs.
Deterministic and probabilistic sensitivity analyses were performed to evaluate model uncertainty.
Results.
The most effective strategy was pembrolizumab for MSI-H patients and ramucirumab/paclitaxel for all other patients, adding 3.8 months or 2.0 quality-adjusted months compared to paclitaxel.
However, this strategy resulted in a prohibitively high ICER of $1,074,620/QALY.
The only cost-effective strategy was paclitaxel monotherapy for all patients, with an ICER of $53,705/QALY.
Conclusion.
Biomarker-based treatments with targeted therapies/immunotherapies for second-line metastatic GC patients substantially improve unadjusted and quality-adjusted survival but are not cost-effective at current drug prices.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Lauren, Brianna& Ostvar, Sassan& Silver, Elisabeth& Ingram, Myles& Oh, Aaron& Kumble, Lindsay…[et al.]. 2020. Cost-Effectiveness Analysis of Biomarker-Guided Treatment for Metastatic Gastric Cancer in the Second-Line Setting. Journal of Oncology،Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1188869
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Lauren, Brianna…[et al.]. Cost-Effectiveness Analysis of Biomarker-Guided Treatment for Metastatic Gastric Cancer in the Second-Line Setting. Journal of Oncology No. 2020 (2020), pp.1-10.
https://search.emarefa.net/detail/BIM-1188869
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Lauren, Brianna& Ostvar, Sassan& Silver, Elisabeth& Ingram, Myles& Oh, Aaron& Kumble, Lindsay…[et al.]. Cost-Effectiveness Analysis of Biomarker-Guided Treatment for Metastatic Gastric Cancer in the Second-Line Setting. Journal of Oncology. 2020. Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1188869
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1188869
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر
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