Abstract 404P
Background
Patients with advanced lung cancer are considered to have a poor prognosis, and recent studies have shown that immunotherapy appears to be associated with improved prognosis and prolonged survival significantly compared with chemotherapy. However, immunotherapy may refer to a comparatively high medical cost and bring severe financial toxicity to patients. In the treatment course of patients with advanced lung cancer, much attention was paid to the safety and efficacy of medications, rather than financial toxicity, which may affect the prognosis and survival indeed. In that case, it is necessary to weigh the profit and the financial toxicity led by immunotherapy.
Methods
We performed a systematic search in Medline on the cost-effectiveness of immunotherapy in patients with advanced lung cancer, and 16 studies were included, consisting of 6 countries, We systematically reviewed the incremental cost for improved quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER) in patients treated with immunotherapy with respect to different countries and different tumor proportion score (TPS) of programmed death receptor-1 ligand (PD-L1).
Results
We found that the willingness to pay (WTP) was not significantly associated with ICER among three western countries (P=0.354). Patients with TPS ≥50%, ≥20%, or ≥1% showed no significant differences in elevated QALYs (P=0.148) and ICER (P=0.263). The elevated QALYs (P=0.024) and ICER of Pembrolizumab were significantly higher than that of Atezolizumab (P=0.045), while there was no significant difference in the cost of elevated QALY between Pembrolizumab and Atezolizumab (P=0.747).
Conclusions
Patients with advanced lung cancer would get profit in the treatment of immunotherapy from different countries, while Pembrolizumab would be associated with a higher benefit and less financial toxicity when taking cost-effectiveness analysis into account. Thus, patients would get more in the immunotherapy when financial toxicity was taken into consideration, and it is necessary to integrate financial toxicity in the clinical decision.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
153P - Mutational landscape of gastric cancer (GC) in adolescents and young adults (AYA) in Asia from 2015-2019
Presenter: Evelyn Yi Ting Wong
Session: e-Poster Display Session
154P - A multicenter, prospective study of apatinib plus chemotherapy as neoadjuvant treatment for locally advanced gastric cancer
Presenter: Yi-Hui Tang
Session: e-Poster Display Session
155P - Surgical outcomes and technical performance of robotic versus laparoscopic total gastrectomy for gastric cancer: A prospective comparative study FUGES-014
Presenter: Hua-Gen Wang
Session: e-Poster Display Session
156P - Safety and feasibility of laparoscopic spleen-preserving splenic hilar lymphadenectomy during total gastrectomy for advanced proximal gastric cancer: A randomized clinical trial
Presenter: Jian-Xian Lin
Session: e-Poster Display Session
157P - Efficacy and safety of penpulimab (AK105), a new generation anti-programmed cell death-1 (PD-1) antibody, in upper gastrointestinal cancers
Presenter: Amy Prawira
Session: e-Poster Display Session
158P - A phase II study of trastuzumab with S-1 plus oxaliplatin for HER2-positive advanced gastric cancer (HIGHSOX study): Final report
Presenter: Atsuo Takashima
Session: e-Poster Display Session
159P - Open surgery can improve the 3-year postoperative survival in some patients with advanced gastric cancer compared with laparoscopic surgery: A multicenter, propensity score matching, in-depth analysis
Presenter: Ze-Ning Huang
Session: e-Poster Display Session
160P - Phase II study of sintilimab combined with FLOT regimen for neoadjuvant treatment of gastric or gastroesophageal junction (GEJ) adenocarcinoma
Presenter: Ning Li
Session: e-Poster Display Session
161P - Adjuvant tegafur/gimeracil/oteracil (S-1) versus platinum-based chemotherapies for resectable gastric cancer: Real-world experience and a propensity score matching analysis
Presenter: Chih Chieh Yen
Session: e-Poster Display Session
162P - Evaluation of neutrophil/lymphocyte ratio (NLR) in monitoring anastomotic leakage after radical total gastrectomy for gastric cancer
Presenter: Ru-Hong Tu
Session: e-Poster Display Session