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.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
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
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.
Inc:incremental cost; Ineff: incremental effect; ICER: incremental cost-effective ratio