CAR-T（CAR-T）细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T（CAR-T）细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
Lisocabtagene Maraleucel 对比 Axicabtagene Ciloleucel 和 Tisagenlecleucel 在美国复发/难治性大 B 细胞淋巴瘤三线或后线治疗中的成本效果
英文原题：Cost-Effectiveness of Lisocabtagene Maraleucel Versus Axicabtagene Ciloleucel and Tisagenlecleucel in the Third-Line or Later Treatment Setting for Relapsed or Refractory Large B-cell Lymphoma in the United States.
查看英文原题
Cost-Effectiveness of Lisocabtagene Maraleucel Versus Axicabtagene Ciloleucel and Tisagenlecleucel in the Third-Line or Later Treatment Setting for Relapsed or Refractory Large B-cell Lymphoma in the United States.
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研究概要
该分析估计，从美国商业支付方角度来看，liso-cel 与 tisa-cel 和 axi-cel 相比具有成本效益。
研究思路结论见上方概要
背景
本研究的目的是从美国商业第三方支付方的角度，评估lisocabtagene maraleucel（liso-cel）与其它可用的CAR-T 细胞疗法，包括axicabtagene ciloleucel（axi-cel）和tisagenlecleucel（tisa-cel），在接受过至少两种既往治疗的患者中的成本效益。
方法
为了捕捉生存结局的这种异质性，我们使用混合治愈模型来外推无进展生存期（PFS）和总生存期（OS）。使用来自TRANSCEND NHL 001中liso-cel的患者水平数据，以及通过Guyot方法重建的来自ZUMA-1中axi-cel、JULIET中tisa-cel和SCHOLAR-1中挽救性化疗的患者水平数据，用于OS和PFS。该模型纳入了与liso-cel、axi-cel和tisa-cel相关的不良事件。
结果
与axi-cel相比，liso-cel成本更低（增量成本为-$74,980），效果略优（增量质量调整生命年[QALY]为0.002）；在基础案例中，与tisa-cel相比，liso-cel的增量成本为$67,925，增量QALY为2.02。敏感性分析结果保持一致，与axi-cel和tisa-cel相比，liso-cel的OS治愈比例是成本效果的主要驱动因素。
展开英文摘要原文
METHODS
To capture this heterogeneity in survival outcomes, we used mixture cure models to extrapolate progression-free survival (PFS) and overall survival (OS). Patient-level data from TRANSCEND NHL 001 for liso-cel and reconstructed patient-level data from ZUMA-1 for axi-cel, JULIET for tisa-cel, and SCHOLAR-1 for salvage chemotherapy, derived using the Guyot method, were used for OS and PFS. The model included adverse events associated with liso-cel, axi-cel, and tisa-cel.
RESULTS
Liso-cel was less costly (incremental cost of - $74,980) and marginally more effective (0.002 incremental quality-adjusted life-years [QALY]) than axi-cel and had an incremental cost of $67,925 and 2.02 incremental QALYs over tisa-cel in the base case. Results remained consistent in sensitivity analyses, with the liso-cel OS cure fraction being the main driver of cost-effectiveness compared with both axi-cel and tisa-cel.
CONCLUSION
This analysis estimated that liso-cel is cost-effective compared with tisa-cel and axi-cel from a commercial US payer perspective.
论文信息
- 作者
- Parker C、Liu FF、Deger KA、Franco-Villalobos C、Proskorovsky I、Keating SJ、Sorensen S
- 第一作者单位
- Bristol Myers Squibb, Uxbridge, UK.United Kingdom
- 通讯作者单位
- Evidence Synthesis, Modeling & Communication, Evidera Inc., 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA. Sonja.sorensen@evidera.com.United States
- 文献类型
- 非美国政府资助研究
- 期刊
- Advances in therapy2023 May
- 原文标识
- PubMed 36947328 · DOI 10.1007/s12325-023-02444-x
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