Background: Adding rh-endostatin to standard platinum-based chemotherapy may significantly improve progression-free and overall survival in patients with advanced non-small cell lung cancer (NSCLC), but the cost-effectiveness of this practice is unclear.
Objective: The purpose of this cost-effectiveness analysis was to estimate the effects of adding rh-endostatin to standard chemotherapy in patients with advanced NSCLC on health and economic outcomes in China.
Methods: A semi-Markov model was constructed to track 3-week patient transitions between 3 health states: progression-free survival, progressed survival, and death. Probabilities were derived mainly from the results of a pivotal Phase III trial assessing the addition of rh-endostatin to standard first-line chemotherapy with vinorelbine-cisplatin in patients with advanced NSCLC. Costs were estimated from the perspective of the Chinese health care system, and the analysis was run over a 10-year time horizon. The primary outcome was the incremental cost-effectiveness ratio (ICER) of adding rh-endostatin at a willingness-to-pay (WTP) threshold of 3 × the per-capita gross domestic product (GDP) per quality-adjusted life-year (QALY) gained. One-way and probabilistic sensitivity analyses were performed.
Results: According to the model, treatment with rh-endostatin plus standard chemotherapy would increase overall survival by 0.63 years and 0.35 QALYs per patient compared with standard chemotherapy, at an additional cost of $8402.60. The ICER for adding rh-endostatin to chemotherapy was $24,454.25/QALY gained (at a 3% discounted rate). On 1-way sensitivity analysis, the utility value of progression-free survival was the most influential factor on the results, followed by the cost of rh-endostatin. On probabilistic sensitivity analysis, the probabilities of cost-effectiveness varied by region due to discrepant per-capita GDPs in China. Modeling to extrapolate clinical survival beyond trial completion was the main limitation.
Conclusion: The findings from the present analysis suggest that the addition of rh-endostatin to standard first-line chemotherapy is unlikely to be cost-effective. However, at a high WTP, rh-endostatin might be a cost-effective treatment option.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clinthera.2011.09.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Efficacy and safety of rh-endostatin (Endostar) combined with pemetrexed/cisplatin followed by rh-endostatin plus pemetrexed maintenance in non-small cell lung cancer: A retrospective comparison with standard chemotherapy.
Thorac Cancer
November 2018
Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Background: Recombinant human endostatin (rh-endostatin) plus standard chemotherapy in advanced non-small cell lung cancer (NSCLC) patients has shown improved efficacy; however, it is unclear whether it is effective and safe when added to pemetrexed/cisplatin and used as maintenance therapy.
Methods: We retrospectively evaluated the data of untreated NSCLC patients administered rh-endostatin plus pemetrexed/cisplatin or pemetrexed/cisplatin. The primary endpoint was progression-free survival (PFS).
Clinical observation on recombinant human endostatin combined with chemotherapy for advanced gastrointestinal cancer.
Asian Pac J Cancer Prev
February 2016
The Third Department of Chemotherapy, Weihai Municipal Hospital, Weihai, Shangdong, China E-mail :
Objective: To explore the clinical efficacy and toxic and side effects of recombinant human endostatin (rh- endostatin/endostar) combined with chemotherapy in the treatment of advanced gastric cancer.
Materials And Methods: A total of 70 patients with advanced gastrointestinal adenocarcioma confirmed by histopathology and/or cytological examination were divided into group A (37 patients) and group B (33 patients). Patients in group A were given intravenous drip of 15 mg endostar added into 500 mL normal saline, once every other day until the cessation of chemotherapy or patients' maximal tolerance to chemotherapy.
A multicenter, open-label, randomized phase II controlled study of rh-endostatin (Endostar) in combination with chemotherapy in previously untreated extensive-stage small-cell lung cancer.
J Thorac Oncol
January 2015
*Department of Oncology, Shanghai Lung Cancer Center, Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China; †Department of Thoracic Cancer, Cancer Center, West China Hospital, Sichuan University, Chengdu, China; ‡Department of Medical Oncology, Hunan Provincial Tumor Hospital, Changsha, Hunan, China; §Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China; ‖The Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; ¶Department of Medical Oncology, Fujian Provincial Tumor Hospital, Fujian Medical University Educational Hospital, Fuzhou, China; #Department of Respiratory Medicine, The First Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing, China; **Chemotherapy Center of Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China; ††Department of Chemotherapy, Affiliated Tumor Hospital, Guangxi Medical University, Guangxi, China; ‡‡Department of Oncology, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China; §§Cancer Center of the First University Hospital, Jilin University, Changchun, China; ‖‖Department of General, Beijing Chest Hospital, Beijing, China; ¶¶Department of Oncology, Second Xiangya Hospital of Central-South University, Changsha, China; and ##Department of Respiratory Disease, Xiang-ya Hospital, Central Southern University, Hunan, Changsha, China.
Background: Based on promising efficacy in a single-arm study, a randomized phase II trial was designed to compare the efficacy and safety of adding rh-endostatin (Endostar) to first-line standard etoposide and carboplatin (EC) chemotherapy for treatment of extensive-stage small-cell lung cancer.
Methods: One hundred forty Chinese patients with pathologically confirmed, extensive-stage small-cell lung cancer were randomly assigned to EC alone or rh-endostatin + EC for 4-6 cycles, followed by single-agent rh-endostatin until progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS).
Cost-effectiveness of adding rh-endostatin to first-line chemotherapy in patients with advanced non-small-cell lung cancer in China.
Clin Ther
October 2011
Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai, China.
Background: Adding rh-endostatin to standard platinum-based chemotherapy may significantly improve progression-free and overall survival in patients with advanced non-small cell lung cancer (NSCLC), but the cost-effectiveness of this practice is unclear.
Objective: The purpose of this cost-effectiveness analysis was to estimate the effects of adding rh-endostatin to standard chemotherapy in patients with advanced NSCLC on health and economic outcomes in China.
Methods: A semi-Markov model was constructed to track 3-week patient transitions between 3 health states: progression-free survival, progressed survival, and death.
[Efficacy and safety of rh-endostatin combined with chemotherapy versus chemotherapy alone for advanced NSCLC: a meta-analysis review].
Zhongguo Fei Ai Za Zhi
May 2011
Department of Medical Oncology, Remmin Hospital of Wuhan University, Wuhan 430060, China.
Background And Objective: In recent years, there has been a large number of studies and reports about the efficacy and safety of recombinant human endostatin (rh-endostatin), an anti-angiogenic drug, in treatment of advanced lung cancer. Authentic assessment of rh-endostatin treatment in lung cancer is important. The aim of this study is to assess the clinical efficacy and safety of rh-endostatin combined with chemotherapy in the treatment of patients with non-small cell lung cancer (NSCLC).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!