Dr. Antonio Calles 🫁🚭 Profile picture
Aug 12, 2021 11 tweets 7 min read Read on X
Cost-Effectiveness Analysis of Durvalumab Plus Chemotherapy in the First-Line Treatment of Extensive-Stage Small Cell Lung Cancer in: Journal of the National Comprehensive Cancer Network. #lcsm #immunonc jnccn.org/view/journals/…
Durvalumab + chemotherapy resulted in an additional 0.27 LYs and 0.20 QALYs, resulting in an ICER of $464,711.90 per QALY versus the chemotherapy treatment. The cost of durvalumab has the greatest influence on this model. More mature follow-up needed for a more stable model, tho.
Subgroup analyses showed that the ICER remained higher than $150,000/QALY (the willingness-to-pay threshold in the United States) across all patient subgroups. #lcsm #immunonc
These results are in line with the previously published analysis from IMpower-133. The cost of atezolizumab has the greatest effect on the results. Therefore, first-line chemo-immunotherapy for unselected population doesn’t seem to be cost-effective from the US perspective. #lcsm
Here it is the publication.
Cost-effectiveness analysis of atezolizumab plus chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer. #lcsm #immunonc
lungcancerjournal.info/article/S0169-…
Atezolizumab plus chemotherapy was estimated to increase costs by $52,881 compared with chemotherapy alone, with a gain of 0.10 quality adjusted life years (QALYs), leading to an incremental cost-effective ratio of $528,810 per QALY. #lcsm #immunonc
Costs apart (they vary upon region), What is the magnitude of clinical benefit of atezolizumab and durvalumab for the treatment of patients with small-cell lung cancer? According to ESMO-MCBS score, not that much. Both agents score 3 in a 5 point scale. #lcsm
Durvalumab ESMO-MCBS scorecard from CASPIAN trial.
esmo.org/guidelines/esm…
Atezolizumab ESMO-MCBS scorecard from IMpower-133 trial.
esmo.org/guidelines/esm…
So, based on the information above, how much are you willing to pay for either atezolizumab or durvalumab for the treatment of patients with ES-SCLC in your jurisdiction?
(costs in $ per patient/year) #lcsm
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More from @Tony_Calles

Apr 19, 2020
🦠 #COVID19 & #Cancer🧬
⚠️Preliminary information from our own experience in lung cancer patients with #COVID19. #LCSM #OncoAlert
So far n=20 with SARS-CoV-2 confirmed by PCR.
🧶 Thread 👇
📊But first, quick poll: How many lung cancer patients with #COVID19 have you already attended?
🔎Expected demographic distribution reflecting our regular clinical practice.
Mean age 65 yo; pathology: 63% ADK, 21% SqCC, 11% SCLC; Stage IV 79%, III 16%, I-II 5%.
Prevalence of men (84%) in infected but without apparent differences by gender in mortality.
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