| Abstrakt: |
Background: Considering clinical benefits of new combination therapies for metastatic renal-cell carcinoma (mRCC), this study aims to calculate the number needed to treat (NTT) and the cost of preventing an event (COPE) for pembrolizumab plus axitinib (PþA), and nivolumab plus ipilimumab (NþI) as first-line treatments, from the Brazilian private perspective. Methods: Overall survival (OS) and progression-free survival (PFS) data for intermediate- and poor-risk groups were obtained from KEYNOTE-426 and CHECKMATE-214 trials for PþA and NþI, respectively, versus sunitinib as mRCC first-line treatment. Results: Considering a 12-month time horizon, 6 patients should be treated with PþA to prevent one death with sunitinib use, resulting in a COPE of 3,893,903 BRL. Using NþI, NNT for 12-month OS rate was 13 compared to sunitinib, with a COPE of 6,357,965 BRL. Regarding PFS data, NNT was also 6 when comparing PþA versus sunitinib, with an estimated COPE of 3,893,903 BRL. Estimated NNT was 20 comparing NþI and sunitinib, resulting in a COPE of 10,172,744 BRL. Cost differences between two treatment options, reached more than 6 million BRL for PFS, and 2 million BRL for OS. Conclusion: At the 12-month landmark, PþA suggests better economic scenario versus NþI as firstline mRCC treatment option for intermediate- and poor-risk groups, through an indirect comparison using sunitinib as a common comparator. [ABSTRACT FROM AUTHOR] |
