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. 2024 Jan 24;22(1):6.
doi: 10.1186/s12962-024-00515-6.

Cost-effectiveness of pembrolizumab versus chemotherapy in patients with platinum-pretreated, recurrent or metastatic nasopharyngeal cancer

Jing Nie  1 , Huina Wu  1 , Qian Wu  1 , Lihui Liu  1 , Ke Tang  2 , Shuo Wang  2 , Jiyong Wu  3
Affiliations

Cost-effectiveness of pembrolizumab versus chemotherapy in patients with platinum-pretreated, recurrent or metastatic nasopharyngeal cancer

Jing Nie et al. Cost Eff Resour Alloc. .

Abstract

Background: Programmed cell death protein 1 (PD-1) monoclonal antibody, pembrolizumab, is a promising drug for platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (NPC). We aimed to assess the cost-effectiveness of pembrolizumab compared with chemotherapy for Chinese patients in this NPC.

Methods: The cost-effectiveness of pembrolizumab versus chemotherapy was evaluated using a partitioned survival model with a 5-year boundary. Efficacy and toxicity data were derived from the KEYNOTE-122 trials. Economic indicators including life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and lifetime cost were used. One-way analysis and probabilistic sensitivity analysis (PSA) were performed to explore the uncertainties. Additionally, various scenario analyses, including different pembrolizumab price calculations and discount rates were performed.

Results: Pembrolizumab or chemotherapy alone respectively yielded 2.82 QALYs (3.96 LYs) and 2.73 QALYs (3.93 LYs) with an ICER of $422,535 per QALYs ($1,232,547 per LYs). This model was primarily influenced by the price of pembrolizumab. Furthermore, PSA indicated that pembrolizumab had none probability of being cost-effective compared with chemotherapy at a willingness-to- pay (WTP) of $38223. Scenario analyses revealed that irrespective of any potential price reduction or adjustments in the discount rate, no discernible impact on the ultimate outcome was observed.

Conclusion: Pembrolizumab was less cost-effective for patients with platinum-pretreated, recurrent or metastatic NPC compared with chemotherapy in China.

Keywords: Capecitabine; Chemotherapy; Cost-effectiveness; Docetaxel; Gemcitabine; Nasopharyngeal cancer; PD-1; Pembrolizumab.

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Conflict of interest statement

There are no conflicts to declare.

Figures

Fig. 1
Fig. 1
Model structure for Platinum-pretreated, Recurrent or Metastatic NPC. NPC, Nasopharyngeal carcinoma; P, Partitioned survival model; PFS, progression-free survival; PD, progressed disease
Fig. 2
Fig. 2
Tornado diagram of pembrolizumab versus chemotherapy in the one-way deterministic sensitivity analysis. P, probability; PD, progressed disease; PFS, progression-free survival; U, utility
Fig. 3
Fig. 3
1000 Monte Carlo simulation diagram of pembrolizumab versus chemotherapy in the probabilistic sensitivity analysis. ICE, incremental cost-effectiveness
See this image and copyright information in PMC

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References

    1. Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet. 2019;394:64–80. doi: 10.1016/S0140-6736(19)30956-0. - DOI - PubMed
    1. Bossi P, Chan AT, Licitra L, Trama A, Orlandi E, Hui EP, Halamkova J, Mattheis S, Baujat B, Hardillo J, et al. Nasopharyngeal carcinoma: ESMO-EURACAN clinical practice guidelines for diagnosis, treatment and follow-up(dagger) Ann Oncol. 2021;32:452–65. doi: 10.1016/j.annonc.2020.12.007. - DOI - PubMed
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Yang S, Wu S, Zhou J, Chen XY. Screening for nasopharyngeal cancer. Cochrane Database Syst Rev 2015:CD008423. - PMC - PubMed
    1. Adkins DR, Haddad RI. Clinical trial data of Anti-PD-1/PD-L1 therapy for recurrent or metastatic nasopharyngeal carcinoma: a review. Cancer Treat Rev. 2022;109:102428. doi: 10.1016/j.ctrv.2022.102428. - DOI - PubMed