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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Cost-effectiveness of PD-L1 testing and tumor mutational burden testing of immune checkpoint inhibitors for non-small cell lung cancer.

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2019 ASCO Annual Meeting

Abstract No:
e20689

Citation:
J Clin Oncol 37, 2019 (suppl; abstr e20689)

Author(s): Wenqian Li, Lingyu Li, Naifei Chen, Jiuwei Cui; The Cancer Center of the First Hospital of Jilin University, Changchun, China; First Hospital, Jinlin University, Chang Chun, China

Abstract Disclosures

Abstract:

Background: Immunotherapy that targeted programmed death ligand 1 (PD-L1)–programmed death 1 (PD-1) pathway showed great benefit on survival compared with other therapies, especially with certain assessments before. However, the high costs limit its use. This cost-effectiveness analysis aimed to measure the significance of various assessments in immunotherapy. Methods: A decision-tree model was established based on the data of OAK study, we compared the economic benefit between immunotherapy and chemotherapy in no test group, PD-L1 test group and tumor mutational burden(TMB) test group respectively with a willingness-to-pay threshold of 3× the per capita gross domestic product ($29307/quality-adjusted life year [QALY]). Besides, we also balanced the benefit of immunotherapy among different groups. Furthermore, we also considered different costs of TMB tests due to the various methods of detection. Sensitivity analyses were conducted to evaluate the stability. Results: Immunotherapy was cost-effective compared with chemotherapy in all groups. Immunotherapy with PD-L1 test achieved economic benefit when comparing with both TMB test group and no test group. However, TMB test group was not cost-effective compared with no test group. The results from average CE and net benefit were consistent. Tissue-based TMB test was the most cost-effective TMB detection methods. One-way sensitivity analyses reflected the impact of utilities. Conclusions: Immunotherapy was cost-effective compared with chemotherapy. PD-L1 test was the most cost-effective immunotherapy test.

Results of cost-effectiveness analyses.

No test
PD-L1
TMB
AtezolizumabdocetaxelAtezolizumabdocetaxelAtezolizumabdocetaxel
QALY7.99076.14678.25256.08448.23985.9883
COST63244.7721920.7264314.8021243.7592841.2027387.89
InC41324.0543071.0565453.31
Ineff1.84402.16812.2515
ICER22410.3272519866.0754829071.45045

Inc:incremental cost; Ineff: incremental effect; ICER: incremental cost-effective ratio

 
Other Abstracts in this Sub-Category:

 

1. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 110 First Author: Sean Khozin
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

3. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

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