A United States (US) Cost-Effectiveness Analysis of Axicabtagene Ciloleucel Compared to Odronextamab in Third Line or Later (3L+) Diffuse Large B-Cell Lymphoma

作者：Frederick L. Locke, Bradley Kievit, Sally W. Wade, Rob Blisset, Markqayne Ray, Madhu Palivela, Timothy Best, Olalekan O. Oluwole · 发表于：Blood · 年份：2024 · DOI：10.1182/blood-2024-199622 · 被引用次数：1 · 研究领域：CAR-T cell therapy research、Biosimilars and Bioanalytical Methods、Biomedical Ethics and Regulation

Introduction Relapsed/Refractory (R/R) diffuse large B-cell lymphoma (DLBCL) following at least two lines of therapy (2L+) historically carried a poor prognosis. The advent of chimeric antigen receptor T-cell (CAR T) therapy in 2L+ provides patients with a potentially curative treatment. The emergence of bispecific antibodies has also expanded the treatment options in R/R DLBCL. Results of the Phase 2 ELM-2 trial positions odronextamab (odro), a novel bispecific agent, for regulatory approval in 3L+ DLBCL. The current study extends our published discrete event simulation (DES) model which evaluated cost-effectiveness of axicabtagene ciloleucel (axi-cel) versus glofitamab and epcoritamab (Locke et al. Transplant Cell Ther 2024a,b) to now assess the relative cost-effectiveness of axi-cel versus odro in R/R 3L+ DLBCL. Methods A DES model was employed to project lifetime health and economic outcomes for patients initiating either axi-cel or odro in the 3L+ setting for DLBCL. Clinical data was leveraged from Phase 2 trials for axi-cel and odro, ZUMA-1 and ELM-2, respectively. The base case analysis incorporated survival data derived from a matching adjusted indirect treatment comparison of axi-cel and odro. A scenario analysis using a naïve head-to-head comparison was also performed. Mixture cure models were utilized to extrapolate survival data for both treatments given long-term survival benefits seen with axi-cel. Given significant uncertainty for the durability of response for...