Abstract:
INTRODUCTION:Pembrolizumab has been approved in the United States (US) for the first-line treatment of patients with advanced or metastatic urothelial carcinoma, who are ineligible for cisplatin-containing chemotherapy and with tumors expressing programmed death-ligand 1 (PD-L1) (Combined Positive Score ≥ 10), or ineligible for any platinum-containing chemotherapy regardless of PD-L1 status. Long-term KEYNOTE-052 data continue to demonstrate pembrolizumab's meaningful, durable, and well-tolerated antitumor activity. This study evaluates the cost-effectiveness of pembrolizumab versus carboplatin plus gemcitabine as first-line treatment for cisplatin-ineligible patients who have PD-L1-positive tumors from a US third-party healthcare payer's perspective. PATIENTS AND METHODS:A partitioned survival model containing 3 health states (progression-free, progressed, and death) was developed. A simulated treatment comparison and a network meta-analysis were conducted to estimate the comparative efficacy of pembrolizumab versus carboplatin-based chemotherapy. Overall survival, progression-free survival, time on treatment, adverse events, and utilities were modeled using the final analyses of the KEYNOTE-052 trial and 4 studies for carboplatin plus gemcitabine. Cost data were estimated using US standard sources and real-world data. Deterministic, probabilistic, and scenario analyses were conducted to assess the robustness of the results. RESULTS:Over 20 years, pembrolizumab resulted in a mean gain of 2.58 life-years, 2.01 quality-adjusted life-years, and additional costs of $158,561, leading to an incremental cost-effectiveness ratio of $78,925/quality-adjusted life-year compared with carboplatin plus gemcitabine. CONCLUSION:This study suggests that pembrolizumab is cost-effective compared with carboplatin plus gemcitabine as a first-line therapy for patients with advanced or metastatic urothelial carcinoma who are PD-L1-positive.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Hale O,Patterson K,Lai Y,Meng Y,Li H,Godwin JL,Homet Moreno B,Mamtani Rdoi
10.1016/j.clgc.2020.07.006subject
Has Abstractpub_date
2020-07-16 00:00:00eissn
1558-7673issn
1938-0682pii
S1558-7673(20)30166-Xpub_type
杂志文章abstract:BACKGROUND:The complete remission (CR) rate with salvage systemic therapy for urothelial carcinoma (UC) is unclear, and its value as an intermediate end point and association with survival are unknown. MATERIALS AND METHODS:Data from phase II trials of salvage chemotherapy and/or biologic agents were pooled. Data rega...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.09.004
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:In this study we aimed to determine the relationship between prostate-specific antigen (PSA)-related information obtained from the provider and PSA test uptake. With recent focus on patient-provider communication (PC) and the guidelines recommending against PSA tests for prostate cancer (PCa), PC regarding t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.05.002
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Hyperglycemia and hypercholesterolemia are class effects of mammalian target of rapamycin inhibitors. The purpose of this study was to characterize safety and efficacy of patients with metastatic renal cell carcinoma (mRCC) treated with everolimus in RECORD-1 (REnal Cell cancer treatment with Oral RAD001 giv...
journal_title:Clinical genitourinary cancer
pub_type: 临床试验,杂志文章
doi:10.1016/j.clgc.2016.04.011
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Level 1 evidence has demonstrated increased overall survival with cisplatin-based neoadjuvant chemotherapy for patients with muscle-invasive urothelial cancer. Usage remains low, however, in part because neoadjuvant chemotherapy will not be effective for every patient. To identify the patients most likely to...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2016.03.006
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:Anemia is a common morbidity of advanced prostate cancer, and prostate cancer treatment and has been associated with a worse overall survival and reduced quality of life in patients with prostate cancer. We sought to determine if infrequent dosing of darbepoetin alfa is safe and effective in treating anemia in ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.012
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze contemporary trends for diagnosis and treatment of upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS:We identified all cases of UTUC in the National Cancer Database (NCDB) between 2004 and 2013. Data comprising tumor, patient, and facility factors were ex...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.01.015
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors > 7 cm. MATERIALS AND METHODS:We retrospectively analyzed data from 168 patients with tumors > 7 cm who were treated using NSS between 1998 and 2012. RESULTS:Imperative and elective indicatio...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2013.09.004
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:Late locoregional complications in prostate cancer (PCa) affect quality of life and require medical interventions. Our objective was to compare late locoregional complications in men dying of castration-resistant PCa (CRPC) who previously received external-beam radiotherapy (EBRT) to radical prostatectomy ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.08.011
更新日期:2017-09-05 00:00:00
abstract:BACKGROUND:This study examined patient perception of information received, satisfaction with that information, and its relation to health-related quality of life (HRQoL) and clinical and demographic variables before, during, and after radiotherapy (RT) for localized prostate cancer. PATIENTS AND METHODS:In 2010, 2 que...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2013.11.001
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to validate contemporary grading systems, in particular, the Gleason grade group (GGG) 5. PATIENTS AND METHODS:We retrospectively reviewed the clinicopathologic data of 176 patients who underwent radical prostatectomy and whose pathologic results were GGG 4 or 5. The endpoints we...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.08.001
更新日期:2020-08-07 00:00:00
abstract:BACKGROUND:There are no data on the patterns of care and outcome of elderly patients with mRCC treated with sunitinib. In a retrospective study, we assessed the routine use of first-line sunitinib in mRCC patients aged ≥ 70 years. PATIENTS AND METHODS:We reviewed the clinical files of 185 patients aged ≥ 70 years with...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2013.11.005
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:The relationship between endogenous creatinine clearance (eCrCl) and renal function values obtained using mathematical formulas has not yet been fully elucidated, especially in patients with upper tract urothelial carcinoma that are treated with radical nephroureterectomy followed by cisplatin-based chemother...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.04.018
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine the outcomes of young adults with kidney cancer treated during the targeted therapy era and evaluate the impact of young age on survival. MATERIALS AND METHODS:We reviewed the records from 445 patients younger than 55 years with kidney cancer at a single institut...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.09.012
更新日期:2020-04-01 00:00:00
abstract:INTRODUCTION/BACKGROUND:The increase of prostate cancer diagnosis after the introduction of prostate-specific antigen (PSA) screening resulted in overtreatment of patients with low risk tumors. The histological Gleason score (GS) revised in 2005 by the International Society of Urological Pathology (ISUP) is currently t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.01.009
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The urgent need for castration-resistant prostate cancer molecular characterization to guide treatment has been constrained by the disease's predilection to metastasize primarily to bone. We hypothesized that the use of clinical and imaging criteria could maximize tissue acquisition from bone marrow biopsies...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.04.016
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:We compared the short-term oncologic and functional outcomes of salvage focal cryotherapy (SFC) with those of salvage total cryotherapy (STC) for radiotherapy (RT)-persistent/recurrent prostate cancer. MATERIALS AND METHODS:We queried the Cryo On-Line Database registry for men who had undergone SFC and STC ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.11.009
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:We characterized clinical outcomes of patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib who were long-term responders (LTRs), defined as patients having progression-free survival (PFS) > 18 months. PATIENTS AND METHODS:A retrospective analysis of data from 5714 patients with mRCC t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.06.005
更新日期:2017-06-20 00:00:00
abstract:BACKGROUND:The most common presenting symptom of bladder cancer (BCa) is hematuria. The present study was designed to define whether patients taking antiplatelet and/or anticoagulant drugs might experience hematuria at an earlier stage or grade of BCa. PATIENTS AND METHODS:The data from 1532 consecutive patients who p...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.08.003
更新日期:2016-06-01 00:00:00
abstract::Metastatic renal cell carcinoma has long been recognized as an aggressive, therapy-refractory epithelial cancer. Two decades of clinical experience with the biologic response modifiers, such as interferon and interleukin-2, have produced little in the way of clinically meaningful benefit for patients, with the notable...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.3816/cgc.2006.s.003
更新日期:2006-12-01 00:00:00
abstract:INTRODUCTION:There is scarce information regarding nivolumab treatment for metastatic renal cell carcinoma (mRCC) in patients with end-stage renal disease (ESRD). This study investigated the safety and efficacy of nivolumab in patients with mRCC and ESRD. MATERIALS AND METHODS:This 2-center retrospective study evaluat...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.04.004
更新日期:2019-08-01 00:00:00
abstract::The discovery and elucidation of prostaglandin (PG) pathways, particularly the molecular and clinical role of cyclooxygenase-2 (COX-2) function, has been found to have an important role in neoplasia. Current understanding of the role of COX-2 activity and therefore the potential clinical usefulness of COX-2-specific i...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.3816/CGC.2005.n.034
更新日期:2005-12-01 00:00:00
abstract::Active surveillance (AS) has been claimed to avoid overtreatment of prostate cancer (PCa). It remains unclear which patients may benefit from AS. One way to clarify this is to improve the definition of insignificant PCa. PSA and Gleason score--the basic instruments used to select patients for AS--suffer from systemati...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2015.06.001
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate the expression of MIB-1, BCL-2, VEGFR3, and CD31 and their associations with long-term survival in patients with renal cell cancer (RCC). PATIENTS AND METHODS:This study consisted of 224 RCC patients who underwent radical nephrectomy from 1985 to 1995. Follow-up continu...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.014
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:To evaluate stage at presentation and cancer-specific mortality (CSM) in upper urinary tract tumors according to histologic subtype. METHODS:Within the Surveillance, Epidemiology, and End Results registry (SEER, 2004-2016), we identified patients with upper urinary tract tumors with pure variant histology (UTV...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.11.004
更新日期:2020-12-02 00:00:00
abstract:BACKGROUND:There is a lack of molecularly-informed biomarkers for patients with metastatic renal cell carcinoma (RCC). Plasma cell-free DNA (cfDNA) sequencing is a minimally-invasive alternative to tissue for profiling the genome in other cancers but relevance in metastatic RCC remains unclear. MATERIALS AND METHODS:W...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.12.018
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Serum testosterone measurement is recommended to assess the efficacy of androgen deprivation therapy (ADT) and to diagnose castration resistance in patients with prostate cancer (PCa). Currently, the accepted castrate level of serum testosterone is 50 ng/dL. Liquid chromatography and tandem mass spectrometry...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.10.025
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine generic, cancer-specific, and prostate cancer-specific health-related quality of life (HRQoL), pain and changes over time in patients with metastatic castration-resistant prostate cancer (mCRPC) in daily practice. PATIENTS AND METHODS:PRO-CAPRI is an observational,...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.11.015
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Tamoxifen (TAM) has been shown to be active against the bicalutamide-induced breast events (BEs) gynecomastia, and breast pain in patients with prostate cancer (PC). Optimal doses and schedules are not yet established. Debate still exists about whether prophylaxis with TAM is more effective than treatment of...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clgc.2012.03.002
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The present study tested cancer-specific (CSM) and overall mortality (OM) after partial cystectomy (PC) for variant histology bladder cancer (non-urothelial carcinoma of the urinary bladder UCUB), relative to UCUB and relative to radical cystectomy (RC). MATERIALS AND METHODS:Within the Surveillance, Epidem...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.10.016
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Scatter factor, also known as hepatocyte growth factor (SF/HGF), is a polypeptide growth factor thought to be important in the growth and spread of prostatic carcinoma. PATIENTS AND METHODS:Scatter factor/HGF levels in pretreatment plasma samples from 171 men with metastatic hormone-refractory prostate canc...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2006.n.006
更新日期:2006-03-01 00:00:00