Q-TWiST Analysis to Assess Benefit–Risk of Pembrolizumab in Patients with PD-L1–Positive Advanced or Metastatic Non-small Cell Lung Cancer

Min Huang (), M. Catherine Pietanza, Ayman Samkari, James Pellissier, Thomas Burke, Sheenu Chandwani, Fansen Kong and A. Simon Pickard
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Min Huang: Merck & Co., Inc.
M. Catherine Pietanza: Merck & Co., Inc.
Ayman Samkari: Merck & Co., Inc.
James Pellissier: Merck & Co., Inc.
Thomas Burke: Merck & Co., Inc.
Sheenu Chandwani: Merck & Co., Inc.
Fansen Kong: Merck & Co., Inc.
A. Simon Pickard: Second City Outcomes Research

PharmacoEconomics, 2019, vol. 37, issue 1, No 10, 105-116

Abstract: Abstract Objectives Pembrolizumab monotherapy showed significantly longer overall survival and fewer treatment-related adverse events compared to chemotherapy in patients with advanced or metastatic non-small cell lung cancer (NSCLC) with programmed death ligand-1 (PD-L1)–positive tumors in the first-line setting in KEYNOTE (KN)-024 and in those previously treated in KN010. The objective of this analysis was to assess the benefit–risk of pembrolizumab in terms of quality-adjusted survival amongst patients in these trials. Methods The Quality-adjusted Time Without Symptoms of disease progression or Toxicity of treatment (Q-TWiST) analysis was used to compare treatments. Survival time was partitioned into three health states: with toxicity before disease progression, without toxicity before disease progression, and disease progression until death. Health state utilities were estimated using EuroQol-5 Dimensions, 3 Levels (EQ-5D-3L) data collected in the trials. Q-TWiST was calculated as the utility-weighted sum of the mean health state durations. Trial data analyzed included the primary analysis and subsequent data cutoffs. The base-case analysis was based on the most recent analysis of the trials. Results Patients randomized to pembrolizumab had 2.49 months greater Q-TWiST (P value

Date: 2019
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DOI: 10.1007/s40273-018-0752-0

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