Efficacy and pharmacoeconomic evaluations of pyrotinib in the treatment of HER-2 positive metastatic breast cancer based upon real world data
OBJECTIVE To explore the efficacies and economics of pyrotinib versus lapatinib plus other anti-tumor agents for HER-2(human epidermal growth factor receptor-2)positive metastatic breast cancer.METHODS From January 2018 to January 2023,HER-2 positive patients of advanced breast cancer on a therapy of lapatinib or pyrotinib at First Affiliated Hospital of USTC were retrospectively reviewed.They were assigned into two groups of lapatinib and pyrotinib.Basic profiles,clinical outcomes and hospitalization expense were recorded.Progression-free survival(PFS),response rate(RR)and disease control rate(DCR)of two groups were compared.And PFS was utilized as an output index for calculating the value of incremental cost-effectiveness ratio(ICER).RESULTS No significant inter-group differences existed in age,pathological type,pathological stage or treatment regimen.The median PFS of two groups was 3.16 months in lapatinib group and 6.67 months in pyrotinib group(P＜0.05).No significant inter-group difference existed in RR or DCR.Mean total hospitalization expenses were 78 500.51 yuan(lapatinib group)and 144 094.66 yuan(pyrotinib group)respectively.ICER of pyrotinib versus lapatinib was 18 687.79 yuan per month.One-way Sensitivity analysis revealed that hospitalization expense had a greater impact on the results in pyrotinib group.Probabilistic sensitivity analysis indicated that,at a threshold of willingness-to-pay(WTP)＞32 600 yuan/month,the probability of cost-effective of pyrotinib group and lapatinib group was 50％ each.CONCLUSION The treatment efficacy of pyrotinib group is better than that of lapatinib group.Cost-effectiveness analysis revealed that when WTP is greater than 18 687.79 yuan/month,pyrotinib is a cost-effective alternative therapy for HER-2 positive metastatic breast cancer.
pyrotiniblapatinibbreast cancerreal world dataPFScost-effectiveness analysis
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