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吉非替尼或厄洛替尼治疗晚期表皮生长因子受体(EGFR)突变非小细胞肺癌患者的成本效益分析

[The cost-effectiveness analysis of gefitinib or erlotinib in the treatment of advanced EGFR mutant non-small cell lung cancer patients].

作者信息

Ma Yuxiang, Huang Yan, Zhao Hongyun, Liu Junling, Chen Likun, Wu Haiying, Zhou Ningning

机构信息

Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2013 Apr;16(4):203-10. doi: 10.3779/j.issn.1009-3419.2013.04.06.

DOI:10.3779/j.issn.1009-3419.2013.04.06
PMID:23601301
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6000588/
Abstract

BACKGROUND

Targeted therapy in non-small cell lung cancer (NSCLC) had become a research hotspot. Both of gefitinib and erlotinib had already been recommended as first line treatment in epidermal growth factor receptor (EGFR) mutant advanced NSCLC patients. The study aimed to compare the effectiveness and prognosis of advanced NSCLC with gefitinib or erlotinib, as well as the cost-effectiveness ratio of the two drugs.

METHODS

Data of 66 EGFR mutant NSCLC patients who were included in Guangzhou medical insurance were analyzed. The efficacy and adverse reactions were evaluated. All the patients were followed-up regularly and the cost of the treatment was recorded.

RESULTS

The median progression free survival (PFS) of all patients was 15.0 months. 49 patients received gefintib and 17 patients had erlotinib. The PFS for the two groups of patients was 17.5 month and 13 months, respectively (P=0.459). 31 (62.3%) patients had rash in gefitinib group, 16 (94.1%) in erlotinib group. Cost-effectiveness ratio (CER) in gefitinib group was 3,027 RMB per month, while 6,800 RMB in erlotinib group. The incremental cost-effectiveness ratio (ICEA) of erlotinib was 2.25 times of gefitinib.

CONCLUSIONS

For EGFR mutant advanced NSCLC patients, equal efficacy and survival benefit were observed in patients with gefitinib and erlotinib. The adverse reaction was milder in gefitinib group than that of erlotinib group. And with Guangzhou medical insurance, gefitinib had a superior cost-effectiveness ratio.

摘要

背景

非小细胞肺癌(NSCLC)的靶向治疗已成为研究热点。吉非替尼和厄洛替尼均已被推荐作为表皮生长因子受体(EGFR)突变的晚期NSCLC患者的一线治疗药物。本研究旨在比较吉非替尼和厄洛替尼治疗晚期NSCLC的有效性、预后以及两种药物的成本效益比。

方法

分析纳入广州医保的66例EGFR突变的NSCLC患者的数据。评估疗效和不良反应。所有患者均接受定期随访并记录治疗费用。

结果

所有患者的中位无进展生存期(PFS)为15.0个月。49例患者接受吉非替尼治疗,17例患者接受厄洛替尼治疗。两组患者的PFS分别为17.5个月和13个月(P = 0.459)。吉非替尼组有31例(62.3%)患者出现皮疹,厄洛替尼组有16例(94.1%)。吉非替尼组的成本效益比(CER)为每月3027元,而厄洛替尼组为6800元。厄洛替尼的增量成本效益比(ICEA)是吉非替尼的2.25倍。

结论

对于EGFR突变的晚期NSCLC患者,吉非替尼和厄洛替尼的疗效和生存获益相当。吉非替尼组的不良反应比厄洛替尼组更轻。并且在广州医保的情况下,吉非替尼具有更高的成本效益比。

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Updated overall survival results from a randomized phase III trial comparing gefitinib with carboplatin-paclitaxel for chemo-naïve non-small cell lung cancer with sensitive EGFR gene mutations (NEJ002).一项比较吉非替尼与卡铂-紫杉醇用于治疗敏感 EGFR 基因突变的初治非小细胞肺癌的随机 III 期临床试验(NEJ002)的更新总生存结果。
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