| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Atezolizumab vs durvalumab for extensive-stage small cell lung cancer in Japan: a real-world comparative analysis of costs and clinical outcomes. |
| 掲載誌名 | 正式名：Japanese journal of clinical oncology 略 称：Jpn J Clin Oncol ISSNコード：14653621/03682811 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Katsuya Hirano, Akito Hata, Yuta Yamanaka, Toshiyuki Sumi, Motohiro Tamiya, Yuki Sato, Yuko Oya, Kosuke Hamai, Nobuyuki Katakami, Katsuhiko Iwasaki, Tatsuhiro Uenishi, Kinya Kokubo, Ataru Igarashi |
| 発行年月 | 2026/08 |
| 概要 | BACKGROUND:Platinum-etoposide combined with a PD-L1 inhibitor (atezolizumab or durvalumab) is the standard first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). Although phase 3 trials have demonstrated similar efficacy, no direct comparison exists, and differences in treatment cost and resource utilization may influence clinical decision-making.METHODS:In this multicenter retrospective study, real-world data from eight Japanese institutions were analyzed. Patients with ES-SCLC treated with platinum-etoposide plus atezolizumab or durvalumab between August 2018 and December 2022 were included. Individual-level medical costs were calculated from health insurance claims linked to electronic medical records. After propensity score matching and exclusion of cisplatin-treated patients, 128 patients were analyzed. The primary outcome was mean monthly medical cost during immunotherapy. Secondary outcomes included overall survival (OS), immune-related adverse events (irAEs), and prognostic factors.RESULTS:Among 128 patients (mean age, 74 years; 85% male), mean monthly medical cost was significantly lower with atezolizumab than durvalumab (¥1 003 922 [$7183] vs ¥1 596 511 [$11 422]; P < .001). Median OS was comparable (13.9 months [95% CI, 11.7-17.5] vs 14.8 months [95% CI, 10.5-not reached]; P = .92). Grade ≥2 irAEs (11% vs 31%; P = .009) and interstitial lung disease (3% vs 20%; P = .004) were less frequent with atezolizumab. Poor performance status was associated with worse OS, whereas treatment type was not.CONCLUSIONS:Atezolizumab was associated with lower medical costs and similar survival outcomes compared with durvalumab in ES-SCLC, suggesting its use as a clinically comparable option with lower associated costs in Japanese real-world practice. |
| DOI | 10.1093/jjco/hyag128 |
| PMID | 42604595 |