Córdoba Raúl, López-Corral Lucía, Presa María, Martín-Escudero Victoria, Vadgama Sachin, Casado Miguel Ángel, Pardo Carlos
Lymphoma Unit, Department of Haematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain.
Department of Haematology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), 37007 Salamanca, Spain.
Cancers (Basel). 2024 Jul 30;16(15):2712. doi: 10.3390/cancers16152712.
In this study, the health impacts of improving access to treatment with axicabtagene ciloleucel (axi-cel) was assessed in patients with relapsed/refractory diffuse large B-cell lymphoma after ≥2 lines of therapy in Spain. A partitioned survival mixture cure model was used to estimate the lifetime accumulated life years gained (LYG) and quality-adjusted life years (QALYs) per patient treated with axi-cel versus chemotherapy. Efficacy data were extracted from the ZUMA-1 trial for axi-cel and from the SCHOLAR-1 study for chemotherapy. In the base case, the incremental outcomes of axi-cel versus chemotherapy were evaluated in a cohort of 187 patients treated with CAR T-cell therapies, as reported by the "Spanish National Health System Plan for Advanced Therapies", and in the alternative scenario in the full eligible population based on epidemiological estimates (n = 490). Taking those currently treated with axi-cel, compared with chemotherapy, axi-cel provided an additional 1341 LYGs and 1053 QALYs. However, when all eligible patients (n = 490) were treated, axi-cel provided an additional 3515 LYs and 2759 QALYs. Therefore, if all eligible patients were treated with axi-cel rather than those currently treated as per the registry (n = 187), there would have been an additional 303 patients treated, resulting in an additional 2173 LYGs and 1706 QALYs in total. The lack of access in Spain has led to a loss of a substantial number of LYGs and QALYs, and efforts should be made to improve access for all eligible patients.
Cancers (Basel). 2024-7-30
Cochrane Database Syst Rev. 2021-9-13
Clin Lymphoma Myeloma Leuk. 2020-10