Clinical and Economic Outcomes of Treatment Sequences for Intermediate- to Poor-Risk Advanced Renal Cell Carcinoma

作者：Apoorva Ambavane, Shuo Yang, Michael B. Atkins, Sumati Rao, Anshul Shah, Meredith M. Regan, David F. McDermott, M. Dror Michaelson · 发表于：Immunotherapy · 年份：2020 · DOI：10.2217/imt-2019-0199 · 被引用次数：16 · 研究领域：Renal cell carcinoma treatment、Renal and related cancers、Economic and Financial Impacts of Cancer

Aim: To assess the cost–effectiveness of treatment sequences for patients with intermediate- to poor-risk advanced renal cell carcinoma. Patients & methods: A discrete event simulation model was developed to estimate patients’ lifetime costs and survival. Efficacy inputs were derived from the CheckMate 214 and CheckMate 025 studies and network meta-analyses. Safety and cost data were obtained from the published literature. Results: The estimated average quality-adjusted life-years (QALYs) gained was the highest on nivolumab + ipilimumab-initiated sequences (3.6–5.3 QALYs) versus tyrosine kinase inhibitor (TKI)-initiated sequences (2.1–3.7 QALYs). Incremental cost per QALY gained for nivolumab + ipilimumab-initiated sequences was below the willingness-to-pay threshold of $150,000 versus other sequences. Conclusion: Immuno-oncology combination therapy followed by TKIs is cost-effective versus TKI sequences followed by immuno-oncology or sequencing TKIs.