Avoided recurrences and costs with adjuvant atezolizumab for patients with early non-small cell lung cancer in Europe

This study estimated avoided recurrences and treatment costs in patients with stage II-IIIA non-small cell lung cancer treated with adjuvant atezolizumab in five European countries over 10 years (2024–2034). Recurrences and deaths were projected in the presence and absence of adjuvant atezolizumab. Inputs were from the literature with extrapolation of disease-free survival from the IMpower010 trial. Country-level direct costs of treating recurrences were estimated. Adjuvant atezolizumab prevented an estimated 4952 recurrences (2199 locoregional, 2753 metastatic) over 10 years (2024–2034), associated with €264 million savings in treatment costs across the five countries. Adjuvant atezolizumab may provide a meaningful reduction in recurrences and associated treatment costs among patients with early non-small cell lung cancer in Europe. Lung cancer is the leading cause of cancer-related death across Europe. Surgery can cure patients if done before the cancer spreads outside the chest but for many patients the cancer will come back (called “recurrence”). Immunotherapies such as atezolizumab may delay or prevent recurrence if given after surgery (known as “adjuvant” treatment) to appropriate patients, but the benefits for all suitable patients remain unclear. We developed a mathematical model based on clinical trials and real-world data that estimated ~5000 recurrences avoided over a 10-year period when adjuvant atezolizumab was available for eligible patients in 5 European countries. This was associated with decreased costs of treatment ranging 46 to 62 million Euros between the different countries over that time period.