She Longjiang, Tang Siqi, Han Jiaqi, Liu Guichao, Chen Lusi, Zhang Yang, Luo Weijun, Zuo Weihan, Ma Feng, Xiong Yan, Zhang Ning
Department of Nasopharyngeal Oncology, First People's Hospital of Foshan, Foshan, China.
Foshan Key Laboratory of Precision Therapy in Oncology and Neurology, First People's Hospital of Foshan, Foshan, China.
Front Pharmacol. 2025 Jul 9;16:1548710. doi: 10.3389/fphar.2025.1548710. eCollection 2025.
The recently released CONTINUUM trial was the first phase 3 randomized study to demonstrate the efficacy and safety of immunotherapy in high-risk locoregionally advanced nasopharyngeal carcinoma (NPC), showing that sintilimab can bring clinical benefits to these populations.
We developed a Markov model to assess the cost and effectiveness of sintilimab plus standard therapy versus standard therapy alone. The primary outcomes included total costs, life-years, quality adjusted life years (QALYs) and incremental cost-effective ratios (ICERs). A series of sensitivity analyses were conducted to test the stability of the model.
When compared to standard therapy, the addition of sintilimab yielded extra 3.10 QALYs at an increased cost of $24208.60, resulting in an ICER of $7819.669 per QALY. Our one-way sensitivity analysis indicated that the utility of event-free survival and the risk of leukopenia/neutropenia in immunotherapy group were the most influential factors impacting the results. The incorporation of sintilimab alongside standard therapy demonstrated a 95.4% probability of being cost-effective.
First-line induction-concurrent chemoradiotherapy with sintilimab was identified as a cost-effectiveness treatment option for high-risk locoregionally advanced NPC.
最近公布的CONTINUUM试验是第一项证明免疫疗法在高危局部晚期鼻咽癌（NPC）中的疗效和安全性的3期随机研究，表明信迪利单抗可为这些人群带来临床益处。
我们建立了一个马尔可夫模型，以评估信迪利单抗联合标准疗法与单纯标准疗法的成本和效果。主要结果包括总成本、生命年、质量调整生命年（QALY）和增量成本效益比（ICER）。进行了一系列敏感性分析以检验模型的稳定性。
与标准疗法相比，添加信迪利单抗可额外获得3.10个QALY，但成本增加了24208.60美元，导致每QALY的ICER为7819.669美元。我们的单向敏感性分析表明，无事件生存的效用和免疫治疗组中白细胞减少/中性粒细胞减少的风险是影响结果的最主要因素。信迪利单抗与标准疗法联合使用具有95.4%的成本效益概率。
信迪利单抗一线诱导同步放化疗被确定为高危局部晚期NPC的一种具有成本效益的治疗选择。
