University of California, Los Angeles, CA, USA.
Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Cancer Control. 2023 Jan-Dec;30:10732748231182795. doi: 10.1177/10732748231182795.
To evaluate outcomes and cost-effectiveness of targeted therapy sequencing for metastatic and recurrent cervical cancer.
Models were simulated based on phase II and III trials on bevacizumab (bev) from GOG-240, cemiplimab (cemi) from GOG 3016, pembrolizumab (pembro) from KEYNOTE-826, and tisotumab vedotin (tiso) from GOG 3023. Costs were based on IBM Micromedex RED BOOK™ and company listed costs.
For [chemo + bev → chemo], total cost was $125,918.04, with median overall survival (mOS) of 21.8 months, and cost-effectiveness ratio (CER) of $119,835.79. For [chemo + bev → cemi], total cost was $187,562.99 with mOS of 28.5 months and CER of $162,039.16. For [chemo + bev + pembro → chemo], total cost was $319,963.78 with mOS 32.9 months and CER of $249,930.10. For [chemo + bev + pembro → tiso], total cost was $455,204.45, with mOS 36.5 months and CER of $320,072.99.
The combination of immunotherapies and biologics have significantly increased overall survival, but with associated higher costs, primarily related to drug costs.
评估转移性和复发性宫颈癌靶向治疗序贯治疗的结局和成本效益。
基于 GOG-240 中的贝伐珠单抗（bev）、GOG 3016 中的西妥昔单抗（cemi）、KEYNOTE-826 中的派姆单抗（pembro）和 GOG 3023 中的替妥昔单抗 vedotin（tiso）的 II 期和 III 期试验，建立模型。成本基于 IBM Micromedex RED BOOK™ 和公司列出的成本。
对于 [化疗+贝伐珠单抗→化疗]，总费用为 125918.04 美元，中位总生存期（mOS）为 21.8 个月，成本效益比（CER）为 119835.79 美元。对于 [化疗+贝伐珠单抗→西妥昔单抗]，总费用为 187562.99 美元，mOS 为 28.5 个月，CER 为 162039.16 美元。对于 [化疗+贝伐珠单抗+派姆单抗→化疗]，总费用为 319963.78 美元，mOS 为 32.9 个月，CER 为 249930.10 美元。对于 [化疗+贝伐珠单抗+派姆单抗→替妥昔单抗]，总费用为 455204.45 美元，mOS 为 36.5 个月，CER 为 320072.99 美元。
免疫疗法和生物制剂的联合应用显著提高了总生存期，但成本也相应增加，主要与药物成本有关。
