Investigation on the cost–effectiveness of Cetuximab in treatment of colorectal cancer: a systematic review

<b>Aim:</b> Assess the cost–effectiveness of cetuximab, utilized as a monotherapy and in combination with other chemotherapy agents, for the treatment of different types of metastatic colorectal cancer (mCRC). <b>Materials &amp; methods:</b> A systematic literature review of recent studies on the cost effectiveness of cetuximab. <b>Results:</b> The review highlights cetuximab's potential to enhance progression-free survival in mCRC, though its broader clinical effectiveness is subject to ongoing debate. However, its cost–effectiveness compared with bevacizumab or standard chemotherapy regimens like FOLFIRI or FOLFOX remains contested. <b>Conclusion:</b> There are discrepancies in the perceived value of anti-EGFR agents like cetuximab concerning overall survival, quality-adjusted life years and progression-free survival vis-à-vis their costs. Subsequent research should focus on balancing these clinical advantages against the financial implications. In this article, we reviewed studies on the cost–effectiveness of using a drug called Cetuximab to treat advanced colorectal cancer. We found that some studies supported the idea that Cetuximab is cost-effective, meaning it provides good value for the money spent. However, other studies suggested that it may not be cost-effective in some cases. This shows that the cost–effectiveness of Cetuximab can vary depending on different factors. More research is needed to understand when Cetuximab is the best choice for treating colorectal cancer economically. Cetuximab demonstrates cost–effectiveness in the treatment of metastatic colorectal cancer, particularly in combination therapies. Economic evaluations of Cetuximab consider various perspectives, including healthcare system and societal viewpoints. Comparators in cost–effectiveness studies include standard of care treatments and alternative targeted therapies. Outcomes measured in economic evaluations encompass life years gained, quality-adjusted life years and direct and indirect costs. Comprehensive cost estimation methods are utilized, incorporating drug costs, healthcare utilization and adverse event expenses. Sensitivity analyzes are conducted to assess the robustness of cost–effectiveness results and account for uncertainties. Transparent reporting of methods, results and limitations in economic evaluations enhances the credibility of the findings. Discounting of costs and outcomes over time is appropriately applied in economic evaluations to reflect time preferences. The relevance of study findings to the research question and systematic review objectives is crucial for drawing meaningful conclusions. The systematic review provides a comprehensive analysis of the methodological quality and risk of bias in economic evaluations of Cetuximab in metastatic colorectal cancer, contributing valuable insights to decision-making processes.

**研究目的**：评估西妥昔单抗（cetuximab）单药治疗或与其他化疗药物联合使用，治疗不同类型转移性结直肠癌（metastatic colorectal cancer, mCRC）的成本效益。**研究材料与方法**：针对西妥昔单抗成本效益相关的近期研究开展系统文献综述。**研究结果**：本综述显示，西妥昔单抗可提升转移性结直肠癌患者的无进展生存期，不过其更广泛的临床有效性仍存在争议。但相较于贝伐珠单抗（bevacizumab）或FOLFIRI、FOLFOX等标准化疗方案，西妥昔单抗的成本效益仍未有定论。**研究结论**：在西妥昔单抗这类抗EGFR药物的价值评估中，其总生存期、质量调整生命年（quality-adjusted life years）以及无进展生存期相关表现与治疗成本之间的匹配度存在分歧。后续研究应聚焦于平衡这类药物的临床优势与经济负担。

本文针对西妥昔单抗治疗晚期结直肠癌的成本效益相关研究进行了综述。部分研究支持西妥昔单抗具备成本效益，即其治疗投入具备合理的性价比；但另有研究表明，在部分场景下西妥昔单抗未必具备成本效益。这说明西妥昔单抗的成本效益会因不同因素而存在差异，仍需开展更多研究以明确在何种情况下西妥昔单抗是结直肠癌治疗的经济最优选择。

西妥昔单抗在转移性结直肠癌的治疗中，尤其是联合治疗场景下，展现出成本效益优势。西妥昔单抗的经济学评价涵盖多种视角，包括医疗卫生系统视角与社会视角。成本效益研究的对照干预措施包括标准治疗方案与其他靶向治疗药物。经济学评价的结局指标包括获得的生命年数、质量调整生命年，以及直接与间接医疗成本。研究采用了全面的成本估算方法，涵盖药物成本、医疗资源使用成本与不良事件治疗成本。此外还开展了敏感性分析，以评估成本效益结果的稳健性并量化不确定性因素。经济学评价中对成本与结局指标进行恰当的跨时间贴现，以反映时间偏好。研究结果需与研究问题及系统综述目标相匹配，才能得出具有实际意义的结论。本系统综述全面分析了西妥昔单抗治疗转移性结直肠癌的经济学评价研究的方法学质量与偏倚风险，为临床决策提供了宝贵参考依据。