A real-world survey on expensive drugs used as first-line chemotherapy in patients with HER2-negative unresectable advanced/recurrent gastric cancer in the stomach cancer study group of the Japan clinical oncology group.

IF 1.9 4区 医学 Q3 ONCOLOGY Japanese journal of clinical oncology Pub Date : 2024-10-03 DOI:10.1093/jjco/hyae104
Tomohiro Nishina, Narikazu Boku, Yukinori Kurokawa, Keita Sasaki, Ryunosuke Machida, Takaki Yoshikawa
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Abstract

Background: Molecular-targeted drugs and immune checkpoint inhibitors have been developed for various malignant diseases, thereby improving clinical outcomes. However, these drugs are expensive, and few studies have assessed their actual use and costs in Japan. This study aimed to survey the use and costs of first-line chemotherapy for advanced/recurrent gastric cancer (AGC) in real-world settings.

Methods: The survey included patients with human epidermal growth factor receptor type2 (HER2)-negative AGC who initiated first-line chemotherapy from January 2022 to December 2022 at the participating 92 institutions in the Japan Clinical Oncology Group. Data on the regimens were collected using Google Forms. A regimen that costs >500 000 Japanese yen (JPY) per month was defined as expensive.

Results: Data on chemotherapy regimens were collected from 2173 patients at all 92 institutions between March 2023 and May 2023. We analyzed 2113 patients who underwent the chemotherapy with recommended regimens and conditionally recommended regimens according to the Japanese Gastric Cancer Treatment Guidelines sixth edition. The expensive regimens were triplet chemotherapy with fluoropyrimidine (S-1 or capecitabine or 5-fluorouracil/levofolinate), oxaliplatin, and nivolumab. Their monthly costs ranged from 767 648 to 771 046 JPY. Nivolumab-containing regimens cost more than 20 times the price of conventional chemotherapy with fluoropyrimidine and oxaliplatin. These regimens were used in 1416 (67%) of 2113 patients: in 71% of patients aged ≤74 years and in 59% of patients aged ≥75 years.

Conclusion: The regimens with >20-fold cost of conventional chemotherapy were used as first-line chemotherapy in two-thirds of patients and more than half even in the elderly population with HER2-negative AGC. This finding is important for future health economic studies on drug cost-efficacy.

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日本临床肿瘤学组胃癌研究小组对HER2阴性不可切除的晚期/复发性胃癌患者一线化疗所用昂贵药物的实际情况调查。
背景:针对各种恶性疾病开发了分子靶向药物和免疫检查点抑制剂,从而改善了临床疗效。然而,这些药物价格昂贵,很少有研究对其在日本的实际使用情况和成本进行评估。本研究旨在调查现实世界中晚期/复发性胃癌(AGC)一线化疗的使用情况和成本:调查对象包括2022年1月至2022年12月期间在日本临床肿瘤学组的92家参与机构接受一线化疗的人表皮生长因子受体2型(HER2)阴性AGC患者。有关治疗方案的数据通过谷歌表格收集。每月费用大于 500 000 日元(JPY)的方案被定义为昂贵方案:结果:我们收集了 2023 年 3 月至 2023 年 5 月期间所有 92 家机构的 2173 名患者的化疗方案数据。我们分析了根据《日本胃癌治疗指南》第六版接受推荐方案和有条件推荐方案化疗的 2113 名患者。昂贵的化疗方案是氟嘧啶(S-1 或卡培他滨或 5-氟尿嘧啶/赖呋酸)、奥沙利铂和尼伐单抗三联化疗。其每月费用从 767 648 日元到 771 046 日元不等。含尼伐单抗的治疗方案的费用是含氟嘧啶和奥沙利铂的传统化疗方案的 20 多倍。2113例患者中有1416例(67%)使用了这些方案:71%的患者年龄≤74岁,59%的患者年龄≥75岁:结论:三分之二的HER2阴性AGC患者将常规化疗成本大于20倍的方案作为一线化疗方案,即使在老年人群中也有半数以上的患者将常规化疗成本大于20倍的方案作为一线化疗方案。这一发现对未来有关药物成本效益的卫生经济学研究具有重要意义。
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来源期刊
CiteScore
3.70
自引率
8.30%
发文量
177
审稿时长
3-8 weeks
期刊介绍: Japanese Journal of Clinical Oncology is a multidisciplinary journal for clinical oncologists which strives to publish high quality manuscripts addressing medical oncology, clinical trials, radiology, surgery, basic research, and palliative care. The journal aims to contribute to the world"s scientific community with special attention to the area of clinical oncology and the Asian region. JJCO publishes various articles types including: ・Original Articles ・Case Reports ・Clinical Trial Notes ・Cancer Genetics Reports ・Epidemiology Notes ・Technical Notes ・Short Communications ・Letters to the Editors ・Solicited Reviews
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