Welcome to Chinese Journal of Clinical Pharmacology and Therapeutics,Today is Chinese

Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2024, Vol. 29 ›› Issue (7): 775-784.doi: 10.12092/j.issn.1009-2501.2024.07.007

Previous Articles     Next Articles

A rapid health technology assessment of camrelizumab in combination with chemotherapy for the first-line treatment of locally advanced/metastatic non-small cell lung cancer

CUI Yanjun1, MA Tian1, LIU Yi1, 2, JIAO Ling1, CHAI Aijun1, FAN Rongrong3, LIU Yanguo3, LUO Xing-xian2, HUANG Lin2, ZHANG Xiaohong2   

  1. 1 Department of Pharmacy, Peking University People's Hospital Shijiazhuang Campus, Shijiazhuang 050000, Hebei, China; 2 Department of Pharmacy, Peking University People's Hospital, Beijing 100044, China; 3 Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100044, China
  • Received:2024-02-18 Revised:2024-03-17 Online:2024-07-26 Published:2024-06-24

Abstract:

AIM: To evaluate the efficacy, safety, and economy of camrelizumab (CAM) combined with platinum-containing chemotherapy (CT) for the first-line treatment of locally advanced/metastatic non-small cell lung cancer (NSCLC). METHODS: Chinese and English databases such as Pubmed, the Cochrane Library, China Knowledge Network, Wanfang Data, and other related websites were systematically searched. After literature screening, quality assessment, and data extraction of the literature according to the inclusion and exclusion criteria, two researchers conducted a rapid health technology assessment (HTA). RESULTS: A total of 7 systematic evaluations/Meta-analyses and 17 economics evaluations were included. In terms of effectiveness, compared to docetaxel chemotherapy, CAM + CT significantly prolonged the overall survival (OS), progression-free survival (PFS), and improved the objective remission rate (ORR) of mutation-negative patients with locally advanced/metastatic NSCLC. Compared with CT and pembrolizumab (PEM), CAM + CT significantly prolonged the PFS, and improved the ORR of mutation-negative patients with locally advanced/metastatic NSCLC. Subgroup analysis showed that CAM + CT significantly prolonged PFS in patients with PD-L1 ≥ 1% and PD-L1 ≥ 50% compared with CT. Compared with CT, CAM + CT significantly prolonged the OS and PFS of mutation-negative patients with locally advanced/metastatic squamous NSCLC. Compared with sintilimab (SIN), CAM + CT significantly prolonged the PFS of mutation-negative patients with locally advanced/metastatic squamous NSCLC. Subgroup analysis showed that CAM + CT significantly prolonged OS in patients with PD-L1 <1% compared with CT. In terms of safety, CAM + CT was comparable in terms of the occurrence of all grades of adverse events, but the incidence of grade 3 or higher treatment-related adverse events was significantly increased compared with CT and PEM for mutation-negative locally advanced/metastatic NSCLC patients. CAM + CT was significantly increased the occurrence of all grades of adverse events compared with CT, but was comparable in terms of the occurrence of grade 3 or higher treatment-related adverse events. In terms of economy, CAM + CT has a cost-effectiveness advantage over CT for patients with mutation-negative advanced/metastatic squamous NSCLC. CAM + CT has a cost-effectiveness advantage over CT and PEM + CT; and CAM + CT does not have a cost-effectiveness advantage over SIN + CT for patients with mutation-negative locally advanced/metastatic non-squamous NSCLC. CONCLUSION: CAM + CT has good efficacy and cost-effectiveness for the first-line treatment of locally advanced/metastatic NSCLC, and the safety aspect is compared with CT, PEM or slightly worse.

Key words: camrelizumab, non-small cell lung cancer, health technology assessment, immune checkpoint inhibitors

CLC Number: