TAG：免疫检查点抑制剂与化疗作为晚期食管鳞状细胞癌二线治疗的比较

2024-03-18 xuyihan MedSci原创发表于上海

信迪利单抗可能是中国晚期口腔鳞状细胞癌二线治疗的最佳选择，其次为替雷利珠单抗和卡瑞利珠单抗。

食管癌是中国第五大最常见和第四大致命的消化系统恶性肿瘤，其中食管鳞状细胞癌(OSCC)约占所有病例的85%。近年来，卡瑞利珠单抗、纳武利尤单抗、帕博利珠单抗、信迪利单抗和替雷利珠单抗等新型PD-1抑制剂被批准用于晚期或转移性OSCC的二线治疗。然而，最佳治疗方案仍不明确。本研究的目的是调查现有PD-1抑制剂的有效性、安全性和经济性，以确定从中国医疗保健系统的角度的最佳治疗。

我们利用PubMed、Web of Science、Cochrane Library、Embase和Scopus数据库进行了一项系统综述，以确定截至2023年8月31日的合格研究。主要观察指标为无进展生存期(PFS)、总生存期(OS)和不良事件(AE)。我们还基于5项临床试验建立了3周间隔的分区生存模型，以预测各种治疗方案的长期成本、质量调整生命年(QALY)和增量成本效益比。直接医疗成本和效用值来源于公共药品招标数据库、临床试验或已发表文献。通过单因素和概率敏感性分析确定模型内参数的不确定性。

共纳入5项随机对照试验，共2837例患者。与本研究中的其他治疗相比，卡瑞利珠单抗的PFS获益最大，帕博利珠单抗的OS获益最大。与其他免疫治疗方案相比，纳武利尤单抗引起的治疗相关AE和3 ~ 5级AE发生率相对较低。在经济学评估中，10年平均费用范围为5433.86美元(化疗)~ 50,617.95美元(纳武利尤单抗)，平均QALY范围为0.55美元(化疗)~ 0.82美元(卡瑞利珠单抗)。帕博利珠单抗因优势被淘汰。在其余策略中，当支付意愿阈值为2022年人均GDP的1、2和3倍时，信迪利单抗、替雷利珠单抗和卡瑞利珠单抗分别是最具成本效益的治疗方案。

本研究发现，信迪利单抗可能是中国晚期口腔鳞状细胞癌二线治疗的最佳选择，其次为替雷利珠单抗和卡瑞利珠单抗。

原文出处：

Liu S, Dou L, Li S. Immune checkpoint inhibitors versus chemotherapy as second-line therapy for advanced oesophageal squamous cell carcinoma: a systematic review and economic evaluation. Therap Adv Gastroenterol. 2024 Feb 28;17:17562848241233134. doi: 10.1177/17562848241233134. PMID: 38425370; PMCID: PMC10903196.

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2024-03-18 1209e435m98(暂无昵称) 来自浙江省

学习了，谢谢分享

21 0
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2024-03-18 1212ad1cm87暂无昵称来自吉林省

不错，学习了。

21 0
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2024-03-19 13013f32m56暂无昵称来自河北省

任凭风吹雨打，只要不放弃，一直走下去，远方的路终将清晰

20 0
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2024-03-18 医鸣惊人来自山西省

认真学习了

20 0
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2024-03-18 梅斯管理员来自上海

#食管鳞状细胞癌（OSCC）# #免疫检查点抑制剂# #化疗#

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