使用从欧洲癌症研究与治疗组织核心生活质量问卷(EORTC QLQ-C30)映射到欧洲五维度健康量表(EQ-5D-3L)和癌症患者生活质量问卷10维度(QLU-C10D)效用值来评估镥[¹⁷⁷Lu]奥曲肽在胃肠胰神经内分泌肿瘤(GEP-NET)患者中的健康相关效用值。
Estimation of Health-Related Utilities for Lu-DOTATATE in GEP-NET Patients Using Utilities Mapped from EORTC QLQ-C30 to EQ-5D-3L and QLU-C10D Utilities.
作者信息
Soare Ioana-Alexandra, Leeuwenkamp Oscar, Longworth Louise
机构信息
PHMR Limited, Berkeley Works, Berkley Grove, London, NW1 8XY, UK.
Advanced Accelerator Applications, a Novartis company, Geneva, Switzerland.
出版信息
Pharmacoecon Open. 2021 Dec;5(4):715-725. doi: 10.1007/s41669-021-00280-9. Epub 2021 Jul 14.
BACKGROUND
Gastroenteropancreatic neuroendocrine tumours (GEP-NET) are a rare, life-threatening type of cancer. The survival benefit of Lu-DOTATATE has been demonstrated in GEP-NET patients. Health technology assessment bodies require data on health-related utility impacts of treatment. A cancer-specific instrument, EORTC QLQ-C30, was used to collect the data for Lu-DOTATATE within clinical studies, but utility-based instruments were not included.
OBJECTIVE
The main aim of this study was to compare EQ-5D-3L and QLU-C10D utilities obtained from EORTC QLQ-C30 using two different approaches. A secondary aim was to analyse the EQ-5D-3L and QLU-C10D utilities of patients treated with Lu-DOTATATE versus best supportive care. A supplementary aim was to evaluate the effect of Lu-DOTATATE on patients' health-related utility over time.
METHODS
Three datasets were used for the analysis. NETTER-1 is a clinical trial, whilst ERASMUS and Guy's and St. Thomas (GStT) are real-world datasets. Two mapping algorithms (response mapping and ordinary least square regression) were applied to generate EQ-5D-3L utilities from EORTC QLQ-C30. An algorithm was used to obtain QLU-C10D utilities from EORTC QLQ-C30.
RESULTS
In all studies, EQ-5D-3L utilities were higher than QLU-C10D utilities at most time points measured, although the magnitude of the differences was small. In NETTER-1, EQ-5D-3L and QLU-C10D utilities were higher in the Lu-DOTATATE arm compared with the octreotide long-acting release (LAR) arm, overall and pre-progression. In all studies, patients' health-related utilities seem to be maintained over time.
CONCLUSION
There were small differences between EQ-5D-3L and QLU-C10D utilities, but these did not translate to relative differences over time or between groups. In NETTER-1, patients in the Lu-DOTATATE arm had higher health-related utilities than patients in the octreotide LAR arm. Health-related utility may at least remain maintained in patients with GEP-NET receiving Lu-DOTATATE.
背景
胃肠胰神经内分泌肿瘤(GEP-NET)是一种罕见的、危及生命的癌症类型。镥-奥曲肽(Lu-DOTATATE)对GEP-NET患者的生存益处已得到证实。卫生技术评估机构需要有关治疗对健康相关效用影响的数据。在临床研究中,使用了一种癌症特异性工具EORTC QLQ-C30来收集镥-奥曲肽的数据,但未纳入基于效用的工具。
目的
本研究的主要目的是使用两种不同方法比较从EORTC QLQ-C30获得的EQ-5D-3L和QLU-C10D效用。次要目的是分析接受镥-奥曲肽治疗的患者与接受最佳支持治疗的患者的EQ-5D-3L和QLU-C10D效用。补充目的是评估镥-奥曲肽随时间对患者健康相关效用的影响。
方法
三个数据集用于分析。NETTER-1是一项临床试验,而ERASMUS以及盖伊和圣托马斯医院(GStT)的数据集是真实世界的数据。应用两种映射算法(响应映射和普通最小二乘回归)从EORTC QLQ-C30生成EQ-5D-3L效用。使用一种算法从EORTC QLQ-C30获得QLU-C10D效用。
结果
在所有研究中,在大多数测量时间点,EQ-5D-3L效用高于QLU-C10D效用,尽管差异幅度较小。在NETTER-1中,总体和疾病进展前,镥-奥曲肽组的EQ-5D-3L和QLU-C10D效用高于长效奥曲肽(LAR)组。在所有研究中,患者的健康相关效用似乎随时间保持稳定。
结论
EQ-5D-3L和QLU-C10D效用之间存在微小差异,但这些差异并未转化为随时间或组间的相对差异。在NETTER-1中,镥-奥曲肽组患者的健康相关效用高于长效奥曲肽组患者。接受镥-奥曲肽治疗的GEP-NET患者的健康相关效用至少可能保持稳定。