Development and validation of a decision model for the evaluation of novel lung cancer treatments in the Netherlands

Recent discoveries in molecular diagnostics and drug treatments have improved the treatment of patients with advanced (inoperable) non-squamous non-small cell lung cancer (NSCLC) from solely platinum-based chemotherapy to more personalized treatment, including targeted therapies and immunotherapies. However, these improvements come at considerable costs, highlighting the need to assess their cost-effectiveness in order to optimize lung cancer care. Traditionally, costeffectiveness models for the evaluation of new lung cancer treatments were based on the findings of the randomized control trial... Mehr ...

Verfasser: Mfumbilwa, Zakile A.
Wilschut, Janneke A.
Simons, Martijn J. H. G.
Ramaekers, Bram
Joore, Manuela
Retèl, Valesca
Cramer‑van der Welle, Christine M.
Schramel, Franz M. N. H.
van de Garde, Ewoudt M. W.
Coupé, Veerle M. H.
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Verlag/Hrsg.: Zenodo
Schlagwörter: Non-small cell lung cancer / NSCLC / Immunotherapy / Targeted Therapy / Health-care evaluation / Whole Genome Sequencing / WGS / Personalized Oncology / Technology Assessment / Next Generation Sequencing / NGS / Discrete events simulation / Real-world data / Decision analytic model
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29219035
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1038/s41598-023-29286-5

Recent discoveries in molecular diagnostics and drug treatments have improved the treatment of patients with advanced (inoperable) non-squamous non-small cell lung cancer (NSCLC) from solely platinum-based chemotherapy to more personalized treatment, including targeted therapies and immunotherapies. However, these improvements come at considerable costs, highlighting the need to assess their cost-effectiveness in order to optimize lung cancer care. Traditionally, costeffectiveness models for the evaluation of new lung cancer treatments were based on the findings of the randomized control trials (RCTs). However, the strict RCT inclusion criteria make RCT patients not representative of patients in the real-world. Patients in RCTs have a better prognosis than patients in a real-world setting. Therefore, in this study, we developed and validated a diagnosis-treatment decision model for patients with advanced (inoperable) non-squamous NSCLC based on real-world data in the Netherlands. The model is a patient-level microsimulation model implemented as discrete event simulation with five health events. Patients are simulated from diagnosis to death, including at most three treatment lines. The base-model (non-personalized strategy) was populated using real-world data of patients treated with platinum-based chemotherapy between 2008 and 2014 in one of six Dutch teaching hospitals. To simulate personalized care, molecular tumor characteristics were incorporated in the model based on the literature. The impact of novel targeted treatments and immunotherapies was included based on published RCTs. To validate the model, we compared survival under a personalized treatment strategy with observed real-world survival. This model can be used for health-care evaluation of personalized treatment for patients with advanced (inoperable) NSCLC in the Netherlands. ; The "Technology Assessment of Next Generation Sequencing in Personalized Oncology" (TANGO) project is funded by the ZonMw Personalised Medicine Programme under Dossier ...