吉非替尼治疗晚期非小细胞肺癌的药物经济学系统评价  

A systematic review of the cost-effectiveness of gefitinib for advanced non-small cell lung cancer

作　　者：赵爽[1] 乔文亮 邱志新[1] 李镭[1] 李为民[1] 

机构地区：[1]四川大学华西医院呼吸与危重症医学科,成都610041 [2]四川大学华西医院肺癌中心,成都610041

出　　处：《华西医学》2018年第1期76-83,共8页West China Medical Journal

基　　金：国家自然科学基金(81372504);四川省重大科研成果转化示范项目(2016CZYD0001)

摘　　要：目的对吉非替尼治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的成本-经济学效益进行系统评价,以明确其药物经济学价值,为临床应用提供依据。方法计算机检索1946年1月—2017年10月Pub Med、Ovid、Embase、Cochrane Library、Medline、中国知网、维普、万方数据库中有关晚期NSCLC患者使用吉非替尼的药物经济学研究的文献,对晚期NSCLC患者使用吉非替尼的药物经济学效益进行系统评价。结果共纳入20项研究,其中一线治疗8篇,二线治疗9篇,三线治疗1篇和稳定期治疗2篇。最常见的药物经济学比较对象是吉非替尼与化学疗法(n=7),此外,还有吉非替尼与厄洛替尼(n=4)、吉非替尼与多西他赛(n=3)、吉非替尼与安慰剂(n=2)、吉非替尼与盐酸埃克替尼(n=2)、吉非替尼与阿法替尼(n=1)以及吉非替尼与其他治疗方式(n=1)。对于晚期NSCLC患者,无论是一线治疗还是二线治疗,吉非替尼均有更好的经济学成本效益,尤其是针对表皮生长因子受体基因突变阳性的患者。作为二线治疗方案,与厄洛替尼和多西他赛相比,吉非替尼也具有更好的经济学成本效益。结论目前在晚期NSCLC患者一二线治疗中使用吉非替尼有较好的成本-经济学效益。Objective To systematically review the cost-effectiveness ofgefitinib for advanced non-small cell lung cancer （NSCLC）, in order to provide the economics values of gefitinib for clinical application. Method We electronically searched databases including PubMed, Ovid, Embase, Cochrane Library, Medline, China National Knowledge Internet, VIP, and Wanfang database for articles about the cost-effectiveness of gefitinib for advanced NSCLC patients from January 1946 to October 2017, and then performed a systematic literature review of economic evaluations of geftinib. Results A total of 20 independent studies were included in the present systematic review, in which 8 were the first-line treatment, 9 were the second-line treatment, 1 was the third-line treatment, and 2 were maintenance treatment. The most common comparison was gefitinib vs. chemotherapy （n=7）, and other comparisons were gefitinib vs. erlotinib （n=4）, gefitinib vs. docetaxel （n=3）, gefitinib vs. placebo （n=2）, gefitinib vs. icotinib （n=2） gefitinib vs. afatinib （n=l） and gefitinib vs. other treatments （n---l）. For the advanced NSCLC patients, the first- or second-line treatment with gefitinib compared to chemotherapy was considered to be more cost-effective, especially in patients with mutated epidermal growth factor receptor gene. As the second-line treatment, gefitinib was considered to be more economical than erlotinib and docetaxel. Conclusion Gefitinib is considered to be a cost-effective strategy for the advanced NSCLC patients as the first- or second-line therapy.

关 键 词：吉非替尼 非小细胞肺癌 成本效益分析 系统评价 

分 类 号：R734.2[医药卫生—肿瘤]