PMID- 33842322
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220422
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 11
DP  - 2021
TI  - Comprehensive Comparison Between Adjuvant Targeted Therapy and Chemotherapy for 
      EGFR-Mutant NSCLC Patients: A Cost-Effectiveness Analysis.
PG  - 619376
LID - 10.3389/fonc.2021.619376 [doi]
LID - 619376
AB  - BACKGROUND: Chemotherapy has been the current standard adjuvant treatment for 
      early-stage non-small-cell lung cancer (NSCLC) patients, while recent studies 
      showed benefits of epidermal growth factor receptor-tyrosine kinase inhibitor 
      (EGFR-TKI). We conducted a cost-effectiveness analysis to comprehensively 
      evaluate the benefit of EGFR-TKI compared with chemotherapy for early-stage 
      EGFR-mutant NSCLC patients after resection from the perspective of the Chinese 
      health care system. METHOD: A Markov model was established. Clinical data were 
      based on the phase 3, ADJUVANT trial, where stage II-IIIA, EGFR-mutant NSCLC 
      patients were randomized into gefitinib group or chemotherapy group after 
      resection. Cost parameters mainly included costs of drugs, examinations, and 
      adverse events (AEs). Effect parameters were evaluated by quality-adjusted life 
      year (QALY). Outcomes contained incremental cost-effective ratio (ICER), average 
      cost-effective ratio (ACER), and net benefit. The willingness-to-pay threshold 
      was set as 3 times per capita gross domestic product ($30,828/QALY). Sensitivity 
      analyses were also conducted to verify the stability of the model. RESULTS: 
      Patients who received gefitinib had both a higher cost ($12,057.98 vs. 
      $11,883.73) and a higher QALY (1.55 vs. 1.42) than patients who received 
      chemotherapy. With an ICER of $1,345.62/QALY, adjuvant gefitinib was of economic 
      benefit compared with chemotherapy. The ACER and net benefit were also consistent 
      (gefitinib vs. chemotherapy, ACER: $7,802.30/QALY vs. $8,392.77/QALY; net 
      benefit: $35,584.85 vs. $31,767.17). Sensitivity analyses indicated the stability 
      of the model and the impact of utility. CONCLUSION: Adjuvant EGFR-TKI application 
      for early-stage EGFR-mutant NSCLC patients was cost-effective compared with 
      chemotherapy, which might provide a reference for clinical decision-making and 
      medical insurance policy formulation in China.
CI  - Copyright (c) 2021 Li, Guo, Li and Cui.
FAU - Li, Wenqian
AU  - Li W
AD  - Cancer Center, The First Hospital of Jilin University, Changchun, China.
FAU - Guo, Hanfei
AU  - Guo H
AD  - Cancer Center, The First Hospital of Jilin University, Changchun, China.
FAU - Li, Lingyu
AU  - Li L
AD  - Cancer Center, The First Hospital of Jilin University, Changchun, China.
FAU - Cui, Jiuwei
AU  - Cui J
AD  - Cancer Center, The First Hospital of Jilin University, Changchun, China.
LA  - eng
PT  - Journal Article
DEP - 20210325
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC8027108
OTO - NOTNLM
OT  - adjuvant therapy
OT  - chemotherapy
OT  - cost-effectiveness analysis
OT  - epidermal growth factor receptor-tyrosine kinase inhibitor
OT  - non-small-cell lung cancer
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/04/13 06:00
MHDA- 2021/04/13 06:01
PMCR- 2021/01/01
CRDT- 2021/04/12 06:23
PHST- 2020/10/20 00:00 [received]
PHST- 2021/03/05 00:00 [accepted]
PHST- 2021/04/12 06:23 [entrez]
PHST- 2021/04/13 06:00 [pubmed]
PHST- 2021/04/13 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2021.619376 [doi]
PST - epublish
SO  - Front Oncol. 2021 Mar 25;11:619376. doi: 10.3389/fonc.2021.619376. eCollection 
      2021.