PMID- 37006537
OWN - NLM
STAT- MEDLINE
DCOM- 20230404
LR  - 20230410
IS  - 2296-2565 (Electronic)
IS  - 2296-2565 (Linking)
VI  - 11
DP  - 2023
TI  - First-line Immuno-chemotherapy for extensive-stage small-cell lung cancer: A 
      network meta-analysis and cost-effectiveness analysis.
PG  - 1028202
LID - 10.3389/fpubh.2023.1028202 [doi]
LID - 1028202
AB  - INTRODUCTION: Many randomized controlled trials have indicated that 
      immuno-chemotherapy could generate clinical benefits, though the cost of 
      immuno-chemotherapy was so prohibitive and the options were varied. This 
      investigation aimed at evaluating effectiveness, safety, and cost-effectiveness 
      for immuno-chemotherapy as a first-line therapeutic option for ES-SCLC patients. 
      METHODS: Multiple scientific literature repositories were searched for clinical 
      studies where immuno-chemotherapy was regarded as the first-line treatment for 
      ES-SCLC, which were published in English between Jan 1, 2000, and Nov 30, 2021. 
      This study conducted a network meta-analysis (NMA) and cost-effectiveness 
      analysis (CEA) based upon US-resident payer perspectives. Overall survival (OS), 
      progression-free survival (PFS), and adverse events (AEs) were evaluated through 
      NMA. In addition, costings, life-years (LYs), quality-adjusted life-years 
      (QALYs), and incremental cost-benefit ratio (ICER) were estimated by CEA. 
      RESULTS: We identified 200 relevant search records, of which four randomized 
      controlled trials (RCTs) (2,793 patients) were included. NMA demonstrated that 
      the effect of atezolizumab plus chemotherapy was ranked at a more elevated 
      position in comparison to other immuno-chemotherapy options and chemotherapy 
      alone, within the general population. The influence of atezolizumab plus 
      chemotherapy and durvalumab plus chemotherapy was ranked higher within 
      populations experiencing non-brain metastases (NBMs) andbrain metastases (BMs), 
      respectively. The CEA revealed that the ICERs of immuno-chemotherapy over 
      chemotherapyalone were higher than the willingness-to-pay (WTP) threshold of 
      $150,000/QALY in any population. However, treatment with atezolizumab plus 
      chemotherapy and durvalumab plus chemotherapy were more favorable health 
      advantages than other immuno-chemotherapy regimens and chemotherapy alone, and 
      the results were 1.02 QALYs and 0.89 QALYs within overall populations and 
      populations with BMs, respectively. CONCLUSION: The NMA and cost-effectiveness 
      investigation demonstrated that atezolizumab plus chemotherapy could be an 
      optimal first-line therapeutic option for ES-SCLC when compared with other 
      immuno-chemotherapy regimens. Durvalumab plus chemotherapy is likely to be the 
      most favorable first-line therapeutic option for ES-SCLC with BMs.
CI  - Copyright (c) 2023 Zhu, Liu, Yang, Zeng and Peng.
FAU - Zhu, Youwen
AU  - Zhu Y
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
FAU - Liu, Kun
AU  - Liu K
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
FAU - Yang, Qiuping
AU  - Yang Q
AD  - Department of Pathology, Tangshan Cancer Hospital, Tangshan, Hebei, China.
FAU - Zeng, Manting
AU  - Zeng M
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
FAU - Peng, Libo
AU  - Peng L
AD  - Department of Oncology, Loudi Central Hospital, Loudi, Hunan, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20230316
PL  - Switzerland
TA  - Front Public Health
JT  - Frontiers in public health
JID - 101616579
SB  - IM
MH  - Humans
MH  - *Cost-Effectiveness Analysis
MH  - Network Meta-Analysis
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Cost-Benefit Analysis
MH  - *Lung Neoplasms/drug therapy
PMC - PMC10061061
OTO - NOTNLM
OT  - cost-effectiveness
OT  - extensive-stage small-cell lung cancer
OT  - immuno-chemotherapy
OT  - network meta-analysis
OT  - quality-adjusted life-years
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- 2023/04/04 06:00
MHDA- 2023/04/04 06:42
PMCR- 2023/03/16
CRDT- 2023/04/03 03:48
PHST- 2022/08/25 00:00 [received]
PHST- 2023/03/03 00:00 [accepted]
PHST- 2023/04/04 06:42 [medline]
PHST- 2023/04/03 03:48 [entrez]
PHST- 2023/04/04 06:00 [pubmed]
PHST- 2023/03/16 00:00 [pmc-release]
AID - 10.3389/fpubh.2023.1028202 [doi]
PST - epublish
SO  - Front Public Health. 2023 Mar 16;11:1028202. doi: 10.3389/fpubh.2023.1028202. 
      eCollection 2023.