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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1477722

Updated cost-effectiveness analysis of tislelizumab in combination with chemotherapy for the first-line treatment of advanced gastric cancer or gastroesophageal junction adenocarcinoma

Provisionally accepted
Lei Xu Lei Xu 1Yunchun Long Yunchun Long 2Lu Yao Lu Yao 3*Weihong Ge Weihong Ge 1*Hao Wang Hao Wang 3*
  • 1 Nanjing University of Chinese Medicine Drum Tower Clinical Medical College, Nanjing, China
  • 2 Meishan People's Hospital, Meishan, China
  • 3 Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Xu Zhou, China

The final, formatted version of the article will be published soon.

    The RATIONALE-305 trial demonstrated that tislelizumab in combination with chemotherapy regimens was more beneficial than chemotherapy regimens alone in the treatment of patients with advanced gastric cancer or gastroesophageal junction adenocarcinoma (GC/GEJC). This study aimed to evaluate the cost-effectiveness of tislelizumab combination chemotherapy in the treatment of advanced GC/GEJC from the perspective of the Chinese health service system.Methods: A three-state partition survival model was constructed to evaluate the economics of tislelizumab combined with chemotherapy as the first-line treatment of advanced GC/GEJC. Clinical data were collected from the RATIONALE-305 trial, and the incremental cost-effectiveness ratio (ICER) was calculated using quality-adjusted life years (QALYs) as the output index. The stability of the results was verified using sensitivity and subgroup analyses. In addition, scenario analysis was conducted for the model simulation time and different parameter extrapolation models.The results of basic analysis showed an increase of 0.31 QALYs in the tislelizumab group compared with the placebo group (1.53 QALYs vs 1.22 QALYs), and a concomitant increase in cost of 10,326.68 USD, with an ICER of 33,876.38 USD/QALY, which is less than the current Chinese willingness-to-pay threshold (36,924.80 USD/QALY). Sensitivity analyses demonstrated that the utility values of progression-free survival, progressive disease and the price of capecitabine had a greater impact on the model. Subgroup analysis revealed that combination therapy was equally costeffective in people with a program death ligand 1 tumor area positivity score of ≥5%.From the perspective of the Chinese health service system, the treatment of advanced GC/GEJC with tislelizumab combined with chemotherapy has a cost-effective advantage over chemotherapy alone.

    Keywords: tislelizumab, Advanced gastric cancer, Gastroesophageal junction adenocarcinoma, Cost-Effectiveness, partition survival model, chemotherapy

    Received: 08 Aug 2024; Accepted: 26 Nov 2024.

    Copyright: © 2024 Xu, Long, Yao, Ge and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Lu Yao, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Xu Zhou, China
    Weihong Ge, Nanjing University of Chinese Medicine Drum Tower Clinical Medical College, Nanjing, China
    Hao Wang, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Xu Zhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.