PCN2 - Efficacy and Cost-Effectiveness of Second-Line Chemotherapy in Elderly Patients with Advanced Gastric Cancer

Abstract

Second-line chemotherapy has been shown to benefit patients with advanced gastric cancer (AGC), extending the overall survival (OS) and progression-free survival (PFS). This study aimed to assess the efficacy and cost-effectiveness of second-line treatment for elderly patients with AGC. Medical records and follow-up information of elderly patients (≥70 years) with AGC who received second-line chemotherapy were collected. A Markov model comprising three health states PFS, progressive disease (PD), and death was developed to simulate the process of AGC. Cost was calculated from the perspective of Chinese society. Sensitivity analyses were applied to explore the impact of essential variables. Forty-three elderly patients with AGC receiving second-line chemotherapy were included in our study. The median OS was 6.0 months (95% confidence interval (CI), 3.90–8.10) and PFS was 3.1 months (95% CI, 1.38–4.82), respectively. Treatment with second-line chemotherapy was estimated to increase costs by $1,980.82 compared with best supportive care (BSC), with a gain of 0.103 quality adjusted life years (QALYs). Thus, the incremental cost-effective ratio was $19,231.21/QALY for second-line chemotherapy versus BSC, which was below the threshold of 3×the per capita GDP of China, $23,970.00. The Utility scores of PFD state and PD state were the most influential factors to the model. Second-line chemotherapy was an optimal strategy for elderly AGC patients in China from the efficacy and cost-effectiveness perspective.