Nivolumab in the Treatment of Metastatic Renal Cell Carcinoma

Background: The economic burden of renal cell carcinoma (RCC) had been reported to be significant in a previous review published in 2011. The objective of this study is to perform an updated review by synthesizing economic studies related to the treatment of RCC that were published since the previous review. Methods: We performed a literature search in PubMed, EMBASE, and the Cochrane Library, covering English-language studies published between June 2010 and August 2018. We categorized these articles by type of analyses (cost-effectiveness analysis (CEA), cost analysis, and cost of illness (COI)) and treatment setting (cancer status and treatment), discussed findings from these articles, and synthesized information from each article in summary tables. Results: We identified 52 studies from 2,317 abstracts/titles deemed relevant from the initial search, including 21 CEA, 23 cost, and 8 COI studies. For localized RCC, costs were found to be positively associated with the aggressiveness of the local treatment. For metastatic RCC (mRCC), pazopanib was reported to be cost-effective in the 1st-line setting. We also found that the economic burden of RCC has increased over time. Conclusion: RCC continues to impose a substantial economic burden to the healthcare system. Despite the large number of treatment alternatives now available for advanced RCC, the costeffectiveness and budgetary impact of many new agents remain unknown and warrant greater attention in future research.

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Cost-Effectiveness of Immunotherapy Treatments for Renal Cell Carcinoma: A Systematic Review

Philip

Zhang

Tahir

et al. 2021

KCA

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Background: Kidney cancer exerts significant disease burden in the United States and possesses a rapidly evolving treatment landscape. The expansion of novel systemic treatment approaches and the use of immunotherapy has been accompanied by increased costs over time. However, the cost-effectiveness of immunotherapy in renal cell carcinoma (RCC) has not been fully assessed. The current study presents a systematic review of cost-effectiveness studies of immunotherapy-based treatment in the context of RCC. Methods: A literature search utilizing PubMed, Embase, Web of Science, and the Cochrane Library was undertaken to find articles related to the cost-effectiveness of immunotherapy treatment in renal cell carcinoma (RCC). The inclusion criteria for articles were as follows: English, published between 1983 and 2020 and evaluated cost-effectiveness in any of the currently approved immunotherapies for RCC. Exclusion criteria included being a review article, commentary or editorial, as well as possessing no specific cost-effectiveness evaluation or analysis relevant to the current review. Results: The current review identified 23 studies, published between 2008 and 2020, across 9 different countries. The studies identified tended to focus on patients with locally advanced or metastatic RCC and examined the cost-effectiveness of immunotherapy across various lines of treatment (first-line treatment (n = 13), second-line treatment (n = 8), and first-line and beyond (n = 2). Eight studies examined the use of interferon-alpha (IFN-alpha), with some reports supporting the cost-effectiveness of these agents and an equal number of studies demonstrating the opposite, with sunitinib often demonstrating superior cost bases. The majority, fourteen studies, included the use of novel immune checkpoint inhibitors (nivolumab, ipilimumab, pembrolizumab), half of which found that checkpoint inhibitors were more cost-effective when compared to oral systemic therapies (sunitinib, everolimus, axitinib, pazopanib, and cabozantinib). Discussion: Novel immune checkpoint inhibitors constituted the most frequently examined agents and were likely to be deemed cost-effective as compared to other treatments; although this often required higher willingness-to-pay (WTP) thresholds or healthcare systems that possessed more cost-constraints. These observations have clinical and health system applicability, with the ability to potentially reduce the cost of treatment for locally advanced or metastatic RCC.

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Nivolumab in the Treatment of Metastatic Renal Cell Carcinoma

Cited by 3 publications

References 28 publications

Economic evaluations of cancer immunotherapy: a systematic review and quality evaluation

Economic evaluations of cancer immunotherapy: a systematic review and quality evaluation

Economic Burden of Renal Cell Carcinoma—Part I: An Updated Review

Cost-Effectiveness of Immunotherapy Treatments for Renal Cell Carcinoma: A Systematic Review

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