Evidence-based pharmacoeconomic evaluation of palbociclib in combination with letrozole versus docetaxel in combination with epirubicin in the first-line treatment of advanced breast cancer with epirubicin

doi:10.5246/jcps.2023.03.019

Abstract

Abstract:

In 2015, palbociclib became the first FDA-approved CDK4/6 selective small-molecule tyrosine kinase inhibitor (TKI). CDK4/6 inhibitors have shown significant effects on inhibiting tumor growth, halting disease progression, and improving survival in patients with advanced HR+/HER2-breast cancer. In the present study, we evaluated the effectiveness and affordability of palbociclib in combination with letrozole compared with docetaxel in combination with epirubicin in the first-line treatment of advanced breast cancer by Bayesian analysis and Markov modeling. The results showed that the progression-free survival (PFS) of docetaxel in combination with epirubicin versus palbociclib in combination with letrozole for advanced HR+/HER2-breast cancer was: HR = 1.8, 95% CI = 0.49–5.68, P < 0.1, and the overall survival (OS) was: HR = 1.5, 95% CI = 0.62–5.90, P < 0.1; 3.55 LYs were obtained in the palbociclib combined with letrozole group, with an increase of 0.68 LYs over the docetaxel combined with epirubicin group. The ICER was ￥ 91 494 QALY^–1, which was lower than the national WTP (￥ 161 940 QALY^–1). The results were basically consistent with the results of the primary analysis, indicating that the results of the fundamental analysis were more stable. Palbociclib in combination with letrozole was more effective and economical than docetaxel in combination with epirubicin in the first-line treatment of advanced breast cancer, which deserves clinical attention.

Key words: Palbociclib, Letrozole, Docetaxel, Epirubicin, Breast cancer, Bayesian Meta analysis, Pharmacoeconomic evaluation

Supporting:

Ciyan Peng, Jing Chen, Sini Li, Jianhe Li, Liubao Peng. Evidence-based pharmacoeconomic evaluation of palbociclib in combination with letrozole versus docetaxel in combination with epirubicin in the first-line treatment of advanced breast cancer with epirubicin[J]. Journal of Chinese Pharmaceutical Sciences, 2023, 32(3): 214-222.

Figures/Tables 3

References 30

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