A systematic review of the cost-effectiveness of gefitinib for advanced non-small cell lung cancer_West China Medical Journal

Authors：

ZHAO Shuang ¹ , QIAO Wenliang ² , QIU Zhixin ¹ , LI Lei ¹ ,  LI Weimin ¹

1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Center of Lung Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LI Weimin, Email: weimin003@163.com

Keywords：

Gefitinib; Non-small cell lung cancers; Cost-effectiveness analysis; Systematic review

DOI：

10.7507/1002-0179.201710007

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the cost-effectiveness of gefitinib for advanced non-small cell lung cancer (NSCLC), in order to provide the economics values of gefitinib for clinical application. Method We electronically searched databases including PubMed, Ovid, Embase, Cochrane Library, Medline, China National Knowledge Internet, VIP, and Wanfang database for articles about the cost-effectiveness of gefitinib for advanced NSCLC patients from January 1946 to October 2017, and then performed a systematic literature review of economic evaluations of geftinib. Results A total of 20 independent studies were included in the present systematic review, in which 8 were the first-line treatment, 9 were the second-line treatment, 1 was the third-line treatment, and 2 were maintenance treatment. The most common comparison was gefitinib vs. chemotherapy (n=7), and other comparisons were gefitinib vs. erlotinib (n=4), gefitinib vs. docetaxel (n=3), gefitinib vs. placebo (n=2), gefitinib vs. icotinib (n=2), gefitinib vs. afatinib (n=1), and gefitinib vs. other treatments (n=1). For the advanced NSCLC patients, the first- or second-line treatment with gefitinib compared to chemotherapy was considered to be more cost-effective, especially in patients with mutated epidermal growth factor receptor gene. As the second-line treatment, gefitinib was considered to be more economical than erlotinib and docetaxel. Conclusion Gefitinib is considered to be a cost-effective strategy for the advanced NSCLC patients as the first- or second-line therapy.

Citation： ZHAO Shuang, QIAO Wenliang, QIU Zhixin, LI Lei, LI Weimin. A systematic review of the cost-effectiveness of gefitinib for advanced non-small cell lung cancer. West China Medical Journal, 2018, 33(1): 76-83. doi: 10.7507/1002-0179.201710007 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin, 2016, 66(1): 7-30.
2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3.	Novello S, Barlesi F, Califano R, et al. Metastatic non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2016, 27(Suppl 5): v1-v27.
4.	Lange A, Prenzler A, Frank M, et al. A systematic review of the cost-effectiveness of targeted therapies for metastatic non-small cell lung cancer (NSCLC). BMC Pulm Med, 2014, 14: 192.
5.	Chouaid C, Monnet I, Robinet G, et al. Economic impact of gefitinib for refractory non-small-cell lung cancer: a Markov model-based analysis. Curr Med Res Opin, 2007, 23(7): 1509-1515.
6.	張曉慶, 李玉平, 倪健, 等. 吉非替尼與厄洛替尼治療非小細胞肺癌療效及藥物經濟學評價. 中國新藥與臨床雜志, 2009, 28(11): 837-840.
7.	Brown T, Boland A, Bagust A, et al. Gefitinib for the first-line treatment of locally advanced or metastatic non-small cell lung cancer. Health Technol Assess, 2010, 14(Suppl 2): 71-79.
8.	劉寶. 4種非小細胞肺癌二線藥物治療方案費用比較研究. 中國藥房, 2010, 21(26): 2403-2405.
9.	Horgan AM, Bradbury PA, Amir E, et al. An economic analysis of the INTEREST trial, a randomized trial of docetaxel versus gefitinib as second-/third-line therapy in advanced non-small-cell lung cancer. Ann Oncol, 2011, 22(8): 1805-1811.
10.	de Lima Lopes G Jr, Segel JE, Tan DS, et al. Cost-effectiveness of epidermal gowth factor receptor mutation testing and first-line treatment with gefitinib for patients with advanced adenocarcinoma of the lung. Cancer, 2012, 118(4): 1032-1039.
11.	Thongprasert S, Tinmanee S, Permsuwan U. Cost-utility and budget impact analyses of gefitinib in second-line treatment for advanced non-small cell lung cancer from Thai payer perspective. Asia Pac J Clin Oncol, 2012, 8(1): 53-61.
12.	王開云, 徐城林, 周云萍, 等. 吉非替尼與含鉑方案治療晚期非小細胞肺癌的對照分析. 中國民族民間醫藥, 2012, 21(15): 29-30.
13.	Zhu J, Li T, Wang X, et al. Gene-guided gefitinib Switch maintenance therapy for patients with advanced EGFR mutation-positive non-small cell lung cancer: an economic analysis. BMC Cancer, 2013, 13: 39.
14.	趙子影, 彭六保, 李健和, 等. 吉非替尼在表皮生長因子受體突變的晚期非小細胞肺癌患者一線化療中的成本-效果性分析. 中國醫院藥學雜志, 2013, 33(22): 1853-1857.
15.	陳鵬, 李凱, 王長利, 等. 吉非替尼與化療在晚期非小細胞肺癌二線治療中的藥物經濟學橫斷面調查. 當代醫學, 2013, 19(15): 134-136.
16.	馬宇翔, 黃巖, 趙洪云, 等. 晚期EGFR突變型非小細胞肺癌患者接受吉非替尼或厄洛替尼治療的成本效益分析. 中國肺癌雜志, 2013, 16(4): 203-210.
17.	Lee VW, Schwander B, Lee VH. Effectiveness and cost-effectiveness of erlotinib versus gefitinib in first-line treatment of epidermal growth factor receptor-activating mutation-positive non-small-cell lung cancer patients in Hong Kong. Hong Kong Med J, 2014, 20(3): 178-186.
18.	Zeng XH, Li J, Peng L, et al. Economic outcomes of maintenance gefitinib for locally advanced/metastatic non-small-cell lung cancer with unknown EGFR mutations: a semi-Markov model analysis. PLoS One, 2014, 9(2): e88881.
19.	翁秀連. 吉非替尼與厄洛替尼治療非小細胞肺癌臨床療效比較及藥物經濟學評價. 中國醫藥科學, 2015, 5(1): 100-102.
20.	Narita Y, Matsushima Y, Shiroiwa T, et al. Cost-effectiveness analysis of EGFR mutation testing and gefitinib as first-line therapy for non-small cell lung cancer. Lung Cancer, 2015, 90(1): 71-77.
21.	Arrieta O, Anaya P, Morales-Oyarvide V, et al. Cost-effectiveness analysis of EGFR mutation testing in patients with non-small cell lung cancer (NSCLC) with gefitinib or carboplatin-paclitaxel. Eur J Health Econ, 2016, 17(7): 855-863.
22.	Zhang CX, Zhang H, Shi J, et al. Trial-based cost-utility analysis of icotinib versus gefitinib as second-line therapy for advanced non-small cell lung cancer in China. PLoS One, 2016, 11(3): e0151846.
23.	Lu S, Ye M, Ding L, et al. Cost-effectiveness of gefitinib, icotinib, and pemetrexed-based chemotherapy as first-line treatments for advanced non-small cell lung cancer in China. Oncotarget, 2017, 8(6): 9996-10006.
24.	Chouaid C, Luciani L, LeLay K, et al. Cost-effectiveness analysis of afatinib versus gefitinib for first-line treatment of advanced EGFR-mutated advanced non-small cell lung cancers. J Thorac Oncol, 2017, 12(10): 1496-1502.
25.	Morère JF, Bréchot JM, Westeel V, et al. Randomized phase Ⅱ trial of gefitinib or gemcitabine or docetaxel chemotherapy in patients with advanced non-small-cell lung cancer and a performance status of 2 or 3(IFCT-0301 study). Lung Cancer, 2010, 70(3): 301-307.
26.	Kim ES, Hirsh V, Mok T, et al. Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase Ⅲ trial. Lancet, 2008, 372(9652): 1809-1818.
27.	Maruyama R, Nishiwaki Y, Tamura T, et al. Phase Ⅲ study, V-15-32, of gefitinib versus docetaxel in previously treated Japanese patients with non-small-cell lung cancer. J Clin Oncol, 2008, 26(26): 4244-4252.
28.	Kelly K, Chansky K, Gaspar LE, et al. Phase Ⅲ trial of maintenance gefitinib or placebo after concurrent chemoradiotherapy and docetaxel consolidation in inoperable stage Ⅲ non-small-cell lung cancer: SWOG S0023. J Clin Oncol, 2008, 26(15): 2450-2456.
29.	Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med, 2009, 361(10): 947-957.
30.	Han JY, Park K, Kim SW, et al. First-SIGNAL: first-line single-agent iressa versus gemcitabine and cisplatin trial in never-smokers with adenocarcinoma of the lung. J Clin Oncol, 2012, 30(10): 1122-1128.
31.	Thongprasert S, Duffield E, Saijo N, et al. Health-related quality-of-life in a randomized phase Ⅲ first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients from Asia with advanced NSCLC (IPASS). J Thorac Oncol, 2011, 6(11): 1872-1880.
32.	Lee KH, Lee KY, Jeon YJ, et al. Gefitinib in selected patients with pre-treated non-small-cell lung cancer: results from a phase Ⅳ, multicenter, non-randomized study (SELINE). Tuberc Respir Dis (Seoul), 2012, 73(6): 303-311.
33.	Shao YY, Shau WY, Lin ZZ, et al. Comparison of gefitinib and erlotinib efficacies as third-line therapy for advanced non-small-cell lung cancer. Eur J Cancer, 2013, 49(1): 106-114.
34.	Shi Y, Zhang L, Liu X, et al. Icotinib versus gefitinib in previously treated advanced non-small-cell lung cancer (ICOGEN): a randomised, double-blind phase 3 non-inferiority trial. Lancet Oncol, 2013, 14(10): 953-961.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin, 2016, 66(1): 7-30.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Novello S, Barlesi F, Califano R, et al. Metastatic non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2016, 27(Suppl 5): v1-v27.
4. Lange A, Prenzler A, Frank M, et al. A systematic review of the cost-effectiveness of targeted therapies for metastatic non-small cell lung cancer (NSCLC). BMC Pulm Med, 2014, 14: 192.
5. Chouaid C, Monnet I, Robinet G, et al. Economic impact of gefitinib for refractory non-small-cell lung cancer: a Markov model-based analysis. Curr Med Res Opin, 2007, 23(7): 1509-1515.
6. 張曉慶, 李玉平, 倪健, 等. 吉非替尼與厄洛替尼治療非小細胞肺癌療效及藥物經濟學評價. 中國新藥與臨床雜志, 2009, 28(11): 837-840.
7. Brown T, Boland A, Bagust A, et al. Gefitinib for the first-line treatment of locally advanced or metastatic non-small cell lung cancer. Health Technol Assess, 2010, 14(Suppl 2): 71-79.
8. 劉寶. 4種非小細胞肺癌二線藥物治療方案費用比較研究. 中國藥房, 2010, 21(26): 2403-2405.
9. Horgan AM, Bradbury PA, Amir E, et al. An economic analysis of the INTEREST trial, a randomized trial of docetaxel versus gefitinib as second-/third-line therapy in advanced non-small-cell lung cancer. Ann Oncol, 2011, 22(8): 1805-1811.
10. de Lima Lopes G Jr, Segel JE, Tan DS, et al. Cost-effectiveness of epidermal gowth factor receptor mutation testing and first-line treatment with gefitinib for patients with advanced adenocarcinoma of the lung. Cancer, 2012, 118(4): 1032-1039.
11. Thongprasert S, Tinmanee S, Permsuwan U. Cost-utility and budget impact analyses of gefitinib in second-line treatment for advanced non-small cell lung cancer from Thai payer perspective. Asia Pac J Clin Oncol, 2012, 8(1): 53-61.
12. 王開云, 徐城林, 周云萍, 等. 吉非替尼與含鉑方案治療晚期非小細胞肺癌的對照分析. 中國民族民間醫藥, 2012, 21(15): 29-30.
13. Zhu J, Li T, Wang X, et al. Gene-guided gefitinib Switch maintenance therapy for patients with advanced EGFR mutation-positive non-small cell lung cancer: an economic analysis. BMC Cancer, 2013, 13: 39.
14. 趙子影, 彭六保, 李健和, 等. 吉非替尼在表皮生長因子受體突變的晚期非小細胞肺癌患者一線化療中的成本-效果性分析. 中國醫院藥學雜志, 2013, 33(22): 1853-1857.
15. 陳鵬, 李凱, 王長利, 等. 吉非替尼與化療在晚期非小細胞肺癌二線治療中的藥物經濟學橫斷面調查. 當代醫學, 2013, 19(15): 134-136.
16. 馬宇翔, 黃巖, 趙洪云, 等. 晚期EGFR突變型非小細胞肺癌患者接受吉非替尼或厄洛替尼治療的成本效益分析. 中國肺癌雜志, 2013, 16(4): 203-210.
17. Lee VW, Schwander B, Lee VH. Effectiveness and cost-effectiveness of erlotinib versus gefitinib in first-line treatment of epidermal growth factor receptor-activating mutation-positive non-small-cell lung cancer patients in Hong Kong. Hong Kong Med J, 2014, 20(3): 178-186.
18. Zeng XH, Li J, Peng L, et al. Economic outcomes of maintenance gefitinib for locally advanced/metastatic non-small-cell lung cancer with unknown EGFR mutations: a semi-Markov model analysis. PLoS One, 2014, 9(2): e88881.
19. 翁秀連. 吉非替尼與厄洛替尼治療非小細胞肺癌臨床療效比較及藥物經濟學評價. 中國醫藥科學, 2015, 5(1): 100-102.
20. Narita Y, Matsushima Y, Shiroiwa T, et al. Cost-effectiveness analysis of EGFR mutation testing and gefitinib as first-line therapy for non-small cell lung cancer. Lung Cancer, 2015, 90(1): 71-77.
21. Arrieta O, Anaya P, Morales-Oyarvide V, et al. Cost-effectiveness analysis of EGFR mutation testing in patients with non-small cell lung cancer (NSCLC) with gefitinib or carboplatin-paclitaxel. Eur J Health Econ, 2016, 17(7): 855-863.
22. Zhang CX, Zhang H, Shi J, et al. Trial-based cost-utility analysis of icotinib versus gefitinib as second-line therapy for advanced non-small cell lung cancer in China. PLoS One, 2016, 11(3): e0151846.
23. Lu S, Ye M, Ding L, et al. Cost-effectiveness of gefitinib, icotinib, and pemetrexed-based chemotherapy as first-line treatments for advanced non-small cell lung cancer in China. Oncotarget, 2017, 8(6): 9996-10006.
24. Chouaid C, Luciani L, LeLay K, et al. Cost-effectiveness analysis of afatinib versus gefitinib for first-line treatment of advanced EGFR-mutated advanced non-small cell lung cancers. J Thorac Oncol, 2017, 12(10): 1496-1502.
25. Morère JF, Bréchot JM, Westeel V, et al. Randomized phase Ⅱ trial of gefitinib or gemcitabine or docetaxel chemotherapy in patients with advanced non-small-cell lung cancer and a performance status of 2 or 3(IFCT-0301 study). Lung Cancer, 2010, 70(3): 301-307.
26. Kim ES, Hirsh V, Mok T, et al. Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase Ⅲ trial. Lancet, 2008, 372(9652): 1809-1818.
27. Maruyama R, Nishiwaki Y, Tamura T, et al. Phase Ⅲ study, V-15-32, of gefitinib versus docetaxel in previously treated Japanese patients with non-small-cell lung cancer. J Clin Oncol, 2008, 26(26): 4244-4252.
28. Kelly K, Chansky K, Gaspar LE, et al. Phase Ⅲ trial of maintenance gefitinib or placebo after concurrent chemoradiotherapy and docetaxel consolidation in inoperable stage Ⅲ non-small-cell lung cancer: SWOG S0023. J Clin Oncol, 2008, 26(15): 2450-2456.
29. Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med, 2009, 361(10): 947-957.
30. Han JY, Park K, Kim SW, et al. First-SIGNAL: first-line single-agent iressa versus gemcitabine and cisplatin trial in never-smokers with adenocarcinoma of the lung. J Clin Oncol, 2012, 30(10): 1122-1128.
31. Thongprasert S, Duffield E, Saijo N, et al. Health-related quality-of-life in a randomized phase Ⅲ first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients from Asia with advanced NSCLC (IPASS). J Thorac Oncol, 2011, 6(11): 1872-1880.
32. Lee KH, Lee KY, Jeon YJ, et al. Gefitinib in selected patients with pre-treated non-small-cell lung cancer: results from a phase Ⅳ, multicenter, non-randomized study (SELINE). Tuberc Respir Dis (Seoul), 2012, 73(6): 303-311.
33. Shao YY, Shau WY, Lin ZZ, et al. Comparison of gefitinib and erlotinib efficacies as third-line therapy for advanced non-small-cell lung cancer. Eur J Cancer, 2013, 49(1): 106-114.
34. Shi Y, Zhang L, Liu X, et al. Icotinib versus gefitinib in previously treated advanced non-small-cell lung cancer (ICOGEN): a randomised, double-blind phase 3 non-inferiority trial. Lancet Oncol, 2013, 14(10): 953-961.

West China Medical Journal

A systematic review of the cost-effectiveness of gefitinib for advanced non-small cell lung cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content