PMID- 35668931
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Chemo-Immunotherapy Regimes for Recurrent or Metastatic Nasopharyngeal Carcinoma: 
      A Network Meta-Analysis and Cost-Effectiveness Analysis.
PG  - 858207
LID - 10.3389/fphar.2022.858207 [doi]
LID - 858207
AB  - Introduction: In 2021, two phase III clinical trials confirmed that toripalimab 
      or camrelizumab combined with gemcitabine and cisplatin (TGP or CGP) provide more 
      benefits in the first-line treatment of R/M NPC than GP. Fortunately, TGP and CGP 
      were recently approved as first-line treatments for cases experiencing R/M NPC by 
      the China National Medical Products Administration in 2021. However, due to the 
      high cost and variety of treatment options, the promotion of 
      chemo-immunotherapeutics in the treatment of R/M NPC remains controversial. 
      Therefore, we performed a cost-effectiveness assessment of the two newly approved 
      treatment strategies to assess which treatments provide the greatest clinical 
      benefits at a reasonable cost. Methods: A cost-effectiveness analysis and network 
      meta-analysis network meta-analysis was conducted based on the JUPITER-02 and 
      CAPTAIN-first Phase 3 randomized clinical trials. A Markov model was expanded for 
      the evaluation of the effectiveness and cost of TGP, CGP, and GP chemotherapy 
      with a 10-years horizon and measured the health achievements in quality-adjusted 
      life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and life-years 
      (LYs). We constructed a treatment strategy and other parameters based on two 
      clinical trials and performed one-way and probabilistic sensitivity experiments 
      for the evaluation of the uncertainty in the model. Results: For the model of 
      patients with treatment-R/M NPC, TGP was associated with a total cost of $48,525 
      and 2.778 QALYs (4.991 LYs), leading to an ICER of $15,103 per QALY ($10,321 per 
      LY) compared to CGP. On comparing the GP chemotherapy, we found TGP and CGP 
      incurred substantial health costs, resulting in ICERs of $19,726 per QALY and 
      $20,438 per QALY, respectively. The risk of adverse events (AEs) and the price of 
      the drugs had significant impacts on the ICER. At the assumed willingness-to-pay 
      (WTP) threshold of $35,673 per QALY, there were approximately 75.8 and 68.5% 
      simulations in which cost-effectiveness was achieved for TGP and CGP, 
      respectively. Conclusion: From the Chinese payer's perspective, TGP is more 
      possible to be a cost-effective regimen compared with CGP and GP for first-line 
      treatment of patients with R/M NPC at a WTP threshold of $35,673 per QALY.
CI  - Copyright (c) 2022 Zhu, Liu, Ding, Wang, Liu and Tan.
FAU - Zhu, Youwen
AU  - Zhu Y
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Liu, Kun
AU  - Liu K
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Ding, Dong
AU  - Ding D
AD  - Department of Oncology, Enshi Central Hospital, Wuhan University, Hubei, China.
FAU - Wang, Kailing
AU  - Wang K
AD  - Department of Gastroenterology, Xiangya Hospital, Central South University, 
      Changsha, China.
FAU - Liu, Xiaoting
AU  - Liu X
AD  - Health Management Center, Brain Hospital of Hunan Province, Changsha, China.
FAU - Tan, Xiao
AU  - Tan X
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20220520
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC9163401
OTO - NOTNLM
OT  - camrelizumab
OT  - cost-effectiveness
OT  - gemcitabine and cisplatin
OT  - recurrent or metastatic nasopharyngeal carcinoma
OT  - toripalimab
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- 2022/06/08 06:00
MHDA- 2022/06/08 06:01
PMCR- 2022/05/20
CRDT- 2022/06/07 02:20
PHST- 2022/01/19 00:00 [received]
PHST- 2022/04/05 00:00 [accepted]
PHST- 2022/06/07 02:20 [entrez]
PHST- 2022/06/08 06:00 [pubmed]
PHST- 2022/06/08 06:01 [medline]
PHST- 2022/05/20 00:00 [pmc-release]
AID - 858207 [pii]
AID - 10.3389/fphar.2022.858207 [doi]
PST - epublish
SO  - Front Pharmacol. 2022 May 20;13:858207. doi: 10.3389/fphar.2022.858207. 
      eCollection 2022.