SynthesisJournal for immunotherapy of cancer2018
A systematic review of the cost and cost-effectiveness studies of immune checkpoint inhibitors.
Synthesis in Journal for immunotherapy of cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 186 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
186 citing papers in PubMed, 8 syntheses or guidelines pooled it, 315 citations in OpenAlex.
- Efficacy and safety of PD-1 inhibitors in recurrent or metastatic squamous cell carcinoma of the head and neck: a systematic review and meta-analysis.Oncology reviews · 2026Pooled it
- Reporting Quality in Health Economic Evaluation Studies of Immune Checkpoint Inhibitors: A Systematic Review.Clinical drug investigation · 2025Pooled it
- Cost-Effectiveness of Poly ADP-Ribose Polymerase Inhibitors in Cancer Treatment: A Systematic Review.Frontiers in pharmacology · 2022Pooled it
- Cost-Effectiveness of Pembrolizumab for the treatment of Non-Small-Cell lung cancer: A systematic review.Frontiers in oncology · 2022Pooled it
- Cost-effectiveness of precision diagnostic testing for precision medicine approaches against non-small-cell lung cancer: A systematic review.Molecular oncology · 2021Pooled it
- Economic evaluations of cancer immunotherapy: a systematic review and quality evaluation.Cancer immunology, immunotherapy : CII · 2020Pooled it
- Smokers or non-smokers: who benefits more from immune checkpoint inhibitors in treatment of malignancies? An up-to-date meta-analysis.World journal of surgical oncology · 2020Pooled it
- Cost effectiveness of immune checkpoint inhibitors for treatment of non-small cell lung cancer: A systematic review.PloS one · 2020Pooled it
- Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials.Journal for immunotherapy of cancer · 2020Trial
- Cost-Utility of Laparoscopic Roux-en-Y Gastric Bypass in Chinese Patients with Type 2 Diabetes and Obesity with a BMI ≥ 27.5 kg/m2: a Multi-Center Study with a 4-Year Follow-Up of Surgical Cohort.Obesity surgery · 2019Trial
- Insurance, race, and socioeconomic disparities in systemic therapy receipt for melanoma in the United States: a systematic review.Melanoma management · 2026Review
- Tumour-agnostic immunotherapy: aligning biological rationale, biomarker precision, and real-world implementation.EClinicalMedicine · 2026Review
- Multimodal Artificial Intelligence in Lung Cancer: From Data Integration to Precision Oncology.Cancers · 2026Review
- Safety and immunogenicity of an adjuvant-free peptide vaccine targeting IL-17A: Phase 1 randomized controlled trial.iScience · 2026Article
- Article
- Health care use and costs associated with clinically impactful immune-related adverse events during immune checkpoint inhibitor therapy for non-small cell lung cancer.Journal of managed care & specialty pharmacy · 2026Article
- Asthenia in cancer patients receiving immune checkpoint Inhibitors (ICIs): the MOUSEION-11 systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Review
- Adjuvant chemotherapy for completely resected stage IB-IIA non-small cell lung cancer according to the AJCC 8th edition staging system: a real-world retrospective cohort study based on the SEER database.Translational lung cancer research · 2026Article
- Deciphering the intratumor microbiota in malignant gastrointestinal tumors: multifaceted interplay and clinical implications.Cell communication and signaling : CCS · 2026Review
126 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEscalating healthcare costs are necessitating the practice of value-based oncology. It is crucial to critically evaluate the economic impact of influential but expensive therapies such as immune checkpoint inhibitors (ICIs). To date, no systematic assessment of the cost-effectiveness (CE) of ICIs has been performed.
methodsPRISMA-guided systematic searches of the PubMed database were conducted. Studies of head/neck (n = 3), lung (n = 5), genitourinary (n = 4), and melanoma (n = 8) malignancies treated with ICIs were evaluated. The reference willingness-to-pay (WTP) threshold was $100,000/QALY.
resultsNivolumab was not cost-effective over chemotherapy for recurrent/metastatic head/neck cancers (HNCs). For non-small cell lung cancer (NSCLC), nivolumab was not cost-effective for a general cohort, but increased PD-L1 cutoffs resulted in CE. Pembrolizumab was cost-effective for both previously treated and newly-diagnosed metastatic NSCLC. For genitourinary cancers (GUCs, renal cell and bladder cancers), nivolumab and pembrolizumab were not cost-effective options. Regarding metastatic/unresected melanoma, ipilimumab monotherapy is less cost-effective than nivolumab, nivolumab/ipilimumab, and pembrolizumab. The addition of ipilimumab to nivolumab monotherapy was not adequately cost-effective. Pembrolizumab or nivolumab monotherapy offered comparable CE profiles.
conclusionsWith limited data and from the reference WTP, nivolumab was not cost-effective for HNCs. Pembrolizumab was cost-effective for NSCLC; although not the case for nivolumab, applying PD-L1 cutoffs resulted in adequate CE. Most data for nivolumab and pembrolizumab in GUCs did not point towards adequate CE. Contrary to ipilimumab, either nivolumab or pembrolizumab is cost-effective for melanoma. Despite these conclusions, it cannot be overstated that careful patient selection is critical for CE. Future publication of CE investigations and clinical trials (along with longer follow-up of existing data) could substantially alter conclusions from this analysis.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.