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.

本研究针对2024至2034年十年间，欧洲五个国家中接受阿替利珠单抗（atezolizumab）辅助治疗的II-IIIA期非小细胞肺癌（non-small cell lung cancer）患者，估算了其可避免的复发病例与治疗成本。研究分别模拟了使用与不使用阿替利珠单抗辅助治疗时的复发与死亡情况。研究输入数据源自公开学术文献，并通过IMpower010临床试验推导出无病生存期（disease-free survival）数据。本研究同时估算了各国针对复发的直接治疗成本。2024至2034年十年间，阿替利珠单抗辅助治疗预计可避免4952例复发（其中2199例为局部区域复发，2753例为远处转移性复发），为五个国家带来总计2.64亿欧元的治疗成本节省。在欧洲早期非小细胞肺癌患者群体中，阿替利珠单抗辅助治疗或可显著降低复发率与相关治疗成本。肺癌是欧洲范围内癌症相关死亡的首要诱因。若在癌症扩散至胸腔外之前实施手术，可实现患者治愈，但多数患者仍会出现癌症复发（即"复发"）。对于符合入组指征的患者，术后给予阿替利珠单抗等免疫治疗（即"辅助"治疗，adjuvant treatment）可延缓或预防复发，但该疗法针对所有适宜人群的获益仍不明确。本研究基于临床试验与真实世界数据（real-world data）构建了数学模型，估算得出：在2024至2034年十年间，若为欧洲五个国家的符合入组指征患者提供阿替利珠单抗辅助治疗，可避免约5000例复发。该结果关联的治疗成本在不同国家间降幅介于4600万至6200万欧元之间。