Lorlatinib for treatment of ALK positive non-small cell lung cancer:a rapid health technology assessment
AIM To evaluate the effectiveness,safety and economy of lorlatinib in anaplastic lymphoma kinase(ALK)positive non-small cell lung cancer(NSCLC)patients,and provide evidence for clinical treatment.METHODS Databases such as PubMed,Cochrane Library,CNKI,Wanfang Data,and VIP and Health Technology Assessment(HTA)related websites were searched to collect HTA reports,systematic evaluation/meta-analysis and pharmacoeconomic evaluation of loratinib for ALK positive NSCLC.Select the literature according to the inclusion and exclusion criteria,extract the data,and evaluate the literature quality.Qualitative description was performed.RESULTS A total of 16 literatures were included,involving 11 systematic review/meta-analysis and 5 pharmacoeconomic evaluation.In terms of effectiveness,compared with other ALK-tyrosine kinase inhibitors(TKIs)and chemotherapy as first-line treatment,lorlatinib significantly prolonged the progression free survival(PFS)in ALK positive NSCLC patients.Compared with chemotherapy as a second-or third-line treatment,lorlatinib significantly prolonged PFS and overall survival.In terms of safety,there was no statistical difference among the ALK-TKIs and chemotherapy in the incidence of adverse events(AEs)of grade ≥3,but the incidence of lorlatinib was relatively high.In regards to the serious AEs and AEs leading to treatment discontinuation,lorlatinib was the lowest.In terms of economy,lorlatinib was not cost-effectiveness compared to ensartinib and crizotinib in China,but lorlatinib was cost-effectiveness compared to chemotherapy as a second-or third-line treatment in Greece and Sweden.CONCLUSION Lorlatinib shows good efficacy and safety for ALK positive NSCLC,but its cost-effectiveness after price reduction in China needs further evaluation.
万方数据
维普
