非小細胞肺癌一線免疫治療的成本效果

Cost-effectiveness of First-line Immunotherapy for Non-small Cell Lung Cancer

林建佑(Chien-Yu Lin) ； 楊思雋(Szu-Chun Yang)

《內科學誌》 33卷2期 (2022/04) Pp. 91-101

https://doi.org/10.6314/JIMT.202204_33(2).02

摘要

肺癌是全球死亡率第一的癌症，一線免疫檢查點抑制劑被證實和化療相比能增加總存活期。然而其成本效果也需被考量。本文整理20篇於2017至2020年間探討非小細胞肺癌一線免疫檢查點抑制劑成本效果的期刊論文，包含：KEYNOTE 024、KEYNOTE 042、KEYNOTE 189、KEYNOTE 407、CheckMate 227、IMpower 150、及IMpower 130等臨床試驗。這些分析顯示一線免疫檢查點抑制劑多不敷成本效果。未來宜建構相關的參數，以利台灣肺癌新診療的成本效果評估。

關鍵字

非小細胞肺癌（Non small cell lung cancer） ； 免疫檢查點抑制劑（Immune checkpoint inhibitor） ； 成本效果分析（Cost-effectiveness analysis）

並列摘要

Lung cancer is the leading cause of cancer death, first-line immune checkpoint inhibitors have been reported to provide survival benefits compared with chemotherapy. However, the cost-effectivness should also be evaluated. This article reviewed 20 studies evaluating the cost-effectiveness of first-line immune checkpoint inhibitors for non-small cell lung cancer (NSCLC) between 2017 and 2020. These studies used clinical trial data, including KEYNOTE 024, KEYNOTE 042, KEYNOTE 189, KEYNOTE 407, CheckMate227, IMpower150, and IMpower130. Most of the cost-effectiveness studies appeared to show that first-line immune checkpoint inhibitors for NSCLC were not cost-effective. Constructing model for health technology assesment of lung cancer merits future research.