PDF(Pubmed)
Abstract：
This epidemiological model forecasted reductions in recurrences and recurrence treatment cost savings with adjuvant atezolizumab vs best supportive care among Canadians with stage II-IIIA non-small cell lung cancer (NSCLC) at national and provincial levels. The population had resected, programmed cell death 1 ligand 1 (PD-L1)-high (≥50%), EGFR-, ALK-, stage II-IIIA NSCLC eligible for adjuvant treatment. Patients with recurrence or death and the costs of treating recurrences were estimated for those receiving adjuvant atezolizumab or best supportive care each year (2024-2034). Proportions of patients expected to be event free up to 10 years after treatment initiation were extrapolated with parametric survival analyses. In the base case analysis, 240 fewer recurrences were estimated to occur over 10 years (2024-2034) with adjuvant atezolizumab vs best supportive care across Canada, with 136 (57%) and 104 (43%) fewer locoregional and metastatic recurrences, respectively. Projected costs of treated recurrences were CAD 33.2 million less over 10 years with adjuvant atezolizumab at a national level (adjuvant atezolizumab, CAD 135.8 million; best supportive care, CAD 169.0 million). This model predicts a considerable long-term reduction in recurrences and substantial treatment cost savings with adjuvant atezolizumab vs best supportive care for patients with PD-L1-high early-stage NSCLC in Canada.
摘要：
该流行病学模型预测了在国家和省级II-IIIA期非小细胞肺癌（NSCLC）的加拿大人中，使用阿特珠单抗辅助治疗可降低复发和复发治疗成本。人口已经切除，程序性细胞死亡1配体1（PD-L1）-高（≥50％），EGFR-,ALK-,符合辅助治疗条件的II-IIIA期非小细胞肺癌。对于每年接受阿特珠单抗辅助治疗或最佳支持治疗的患者，估计复发或死亡的患者以及治疗复发的成本（2024-2034）。用参数生存分析推断治疗开始后10年内预期无事件的患者比例。在基本情况分析中，据估计，在10年内（2024-2034年），阿替珠单抗辅助治疗与加拿大的最佳支持治疗相比，复发率减少了240例。减少136例（57%）和104例（43%）局部和转移性复发，分别。在国家一级使用阿特珠单抗辅助治疗的10年内，治疗复发的预计成本减少了3320万CAD（阿特珠单抗辅助治疗，1.358亿加元；最佳支持性护理，加元1.69亿加元）。该模型预测，对于加拿大PD-L1高早期NSCLC患者，阿特珠单抗辅助治疗与最佳支持治疗相比，复发的长期减少和治疗成本的大幅节省。
