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2026年8月13日星期四
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免疫治疗对晚期/转移性肺癌总生存期及医疗费用的影响：一项法国的真实世界研究

Impact of immunotherapy on overall survival and healthcare costs in advanced/metastatic lung cancer: A real-world study in France.

期刊
Lung Cancer
PMID
42497525
原文
PubMed ↗
发布日期

作者

  • Adrien Rousseau — Paris-Saclay University, Gustave Roussy, Department of Cancer Medicine, Thoracic Group and International Center for Thoracic Cancers (CICT), 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: adrien.rousseau@gustaveroussy.fr.
  • Astrid Foix-Colonier — Amaris Consulting, 13 Impasse Serge Reggiani, 44815 Saint-Herblain, France.
  • Joël Luu — Inserm, Oncostat U1018, labeled Ligue Contre le Cancer, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France; Paris-Saclay University, Gustave Roussy, Biostatistics and Epidemiology Department, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
  • Stéphanie Foulon — Inserm, Oncostat U1018, labeled Ligue Contre le Cancer, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France; Paris-Saclay University, Gustave Roussy, Biostatistics and Epidemiology Department, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
  • Benjamin Besse — Paris-Saclay University, Gustave Roussy, Department of Cancer Medicine, Thoracic Group and International Center for Thoracic Cancers (CICT), 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
  • V Valentine Laizet — Amaris Consulting, 360 Rue Saint-Jacques, Montréal, QC H2Y 2N1, Canada.
  • Khalil-Jonathan Jewiti-Rigondza — Amaris Consulting, 7 Rue de Châteaudun, 75009 Paris, France.
  • Alaeddine Sidhom — Amaris Consulting, Carrer de Vilamarí, 86, Eixample, 08015 Barcelona, Spain.
  • Nahla Nacef — Amaris Consulting, Technopole El Ghazala Route de Raoued Km 3.5 Ariana 2088, Tunisia.
  • Aline Gauthier — Amaris Consulting, Carrer de Vilamarí, 86, Eixample, 08015 Barcelona, Spain.
  • M Monia Ezzalfani — Amaris Consulting, 7 Rue de Châteaudun, 75009 Paris, France.
  • Julia Bonastre — Inserm, Oncostat U1018, labeled Ligue Contre le Cancer, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France; Paris-Saclay University, Gustave Roussy, Biostatistics and Epidemiology Department, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.

作者单位

  • Paris-Saclay University, Gustave Roussy, Department of Cancer Medicine, Thoracic Group and International Center for Thoracic Cancers (CICT), 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: adrien.rousseau@gustaveroussy.fr.
  • Amaris Consulting, 13 Impasse Serge Reggiani, 44815 Saint-Herblain, France.
  • Inserm, Oncostat U1018, labeled Ligue Contre le Cancer, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France; Paris-Saclay University, Gustave Roussy, Biostatistics and Epidemiology Department, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
  • Paris-Saclay University, Gustave Roussy, Department of Cancer Medicine, Thoracic Group and International Center for Thoracic Cancers (CICT), 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
  • Amaris Consulting, 360 Rue Saint-Jacques, Montréal, QC H2Y 2N1, Canada.
  • Amaris Consulting, 7 Rue de Châteaudun, 75009 Paris, France.
  • Amaris Consulting, Carrer de Vilamarí, 86, Eixample, 08015 Barcelona, Spain.
  • Amaris Consulting, Technopole El Ghazala Route de Raoued Km 3.5 Ariana 2088, Tunisia.

摘要

中文

尽管免疫治疗在临床试验中显示出显著的总生存期（OS）获益，但其有效性和费用仍需在真实世界环境中加以评估。本研究旨在真实世界条件下评估接受与未接受免疫治疗的晚期/转移性肺癌患者的 OS 和医疗费用。我们利用 2010 至 2020 年法国健康数据系统进行了回顾性分析。2017 至 2020 年间接受免疫治疗的晚期/转移性肺癌患者纳入 IMMUNO 队列。我们设置两个对照队列（ADVANCED 和 METASTATIC），纳入 2012 至 2016 年间（法国免疫治疗报销前）接受首次系统治疗的相似患者。根据免疫治疗线别（IMMUNO-L1、IMMUNO-L2）采用倾向性评分匹配 IMMUNO 患者与对照患者。从法国国家健康保险角度估算一线队列从首次系统治疗起的医疗费用。IMMUNO-L1 队列包含 15,118 例患者，IMMUNO-L2 队列 15,935 例，ADVANCED 队列 47,762 例，METASTATIC 队列 40,137 例。匹配后，IMMUNO-L1 中位 OS 为 14.9 个月（四分位距（IQR）：4.5–43.9），而 IMMUNO-L1 和 METASTATIC-L1 分别为 7.5 个月（IQR：3.3–15.9）和 7.4 个月（IQR：3.4–14.5）。IMMUNO-L1 平均月费用为 €8,801（95% CI：8,684–8,917），ADVANCED-L1 为 €4,205（4,137–4,273），METASTATIC-L1 为 €4,314（4,250–4,378）。IMMUNO-L1 患者人均累计医疗费用为 €57,561（95% CI：56,707–58,414），ADVANCED-L1 为 €14,399（14,182–14,617），METASTATIC-L1 为 €15,121（14,904–15,338）。接受免疫治疗的肺癌患者相较于标准历史化疗方案，显示出更优的真实世界生存获益，但费用更高。然而，免疫治疗在常规实践中的生存获益似乎低于临床试验结果。

English

While immunotherapies have shown a substantial overall survival (OS) benefit in clinical trials, their effectiveness and costs should be assessed in real-world setting. This study aims to assess OS and healthcare costs in advanced/metastatic lung cancer patients treated or not with immunotherapy in real-world setting. We performed a retrospective analysis using the French Health Data System from 2010 to 2020. Patients treated with immunotherapy for advanced/metastatic lung cancer between 2017 and 2020 were included in the IMMUNO cohort. We used two control cohorts (ADVANCED and METASTATIC) of similar patients receiving a first systemic treatment between 2012 and 2016 (before immunotherapy reimbursement in France). Propensity scores were used to match IMMUNO patients and control patients according to immunotherapy line (IMMUNO-L1, IMMUNO-L2). Healthcare costs were estimated from the French national health insurance perspective for first-line cohorts, starting from the first systemic treatment. The IMMUNO-L1 cohort comprised 15,118 patients, the IMMUNO-L2 cohort 15,935 patients, the ADVANCED cohort 47,762 patients and the METASTATIC cohort 40,137 patients. After matching, median OS was 14.9 months (interquartile range (IQR): 4.5-43.9) in IMMUNO-L1 vs 7.5 months (IQR: 3.3-15.9) and 7.4 months (3.4-14.5) in IMMUNO-L1 and METASTATIC-L1 respectively. The average monthly cost was €8,801 [95 %CI: 8,684-8,917] in IMMUNO-L1, €4,205 [4,137-4,273] in ADVANCED-L1 and €4,314 [4,250-4,378] in METASTATIC-L1. The mean cumulated healthcare cost per patient was €57,561 [95 %CI: 56,707-58,414] in IMMUNO-L1, €14,399 [14,182-14,617] in ADVANCED-L1 and €15,121 [14,904-15,338] in METASTATIC-L1. Lung cancer patients treated with immunotherapy show better real-world survival outcomes at a higher cost than standard historical chemotherapy regimens. However, the survival benefit of immunotherapy appears lower in routine practice than in clinical trials.

分类与指标

研究类型
临床研究
病种
肺癌
JCR 分区
Q1
影响因子
5.3
新锐分区
2区