Evidence map›Paper›PMID 30551196›Full record

ArticleJournal of the National Cancer Institute2019

Cost-Effectiveness of Chimeric Antigen Receptor T-Cell Therapy in Pediatric Relapsed/Refractory B-Cell Acute Lymphoblastic Leukemia.

Reith R Sarkar, Nicholas J Gloude, Deborah Schiff, James D Murphy

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 10 pooled it
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 10 syntheses or guidelines pooled it, 123 citations in OpenAlex.

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  5. Dose fractionation of CAR-T cells. A systematic review of clinical outcomes.Journal of experimental & clinical cancer research : CR · 2023
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  16. Posttransplant cells for the win? DLI and adoptive cell therapy to eradicate MRD.Hematology. American Society of Hematology. Education Program · 2025
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Reith R SarkarUniversity of California San Diego School of Medicine, UCSD School of Medicine, La Jolla, CA.
Nicholas J GloudeUniversity of California San Diego School of Medicine, UCSD School of Medicine, La Jolla, CA.
Deborah SchiffUniversity of California San Diego School of Medicine, UCSD School of Medicine, La Jolla, CA.
James D MurphyUniversity of California San Diego School of Medicine, UCSD School of Medicine, La Jolla, CA.
University of California, San Diego · USRady Children's Hospital-San Diego · US

Funding

UC San Diego Clinical and Translational Research InstituteTL1TR001443 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DEPP, COLIN A. · 2015 to 2019
$3.4M
NCATS NIH HHS TL1 TR001443
6 · The paper itself

Abstract

backgroundChimeric antigen receptor T-cell (CAR-T) therapy is a promising new class of cancer therapy but has a high up-front cost. We evaluated the cost-effectiveness of CAR-T therapy among pediatric patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL).

methodsWe built a microsimulation model for pediatric patients with relapsed/refractory B-ALL receiving either CAR-T therapy or standard of care. Outcomes included costs, quality of life (health utility), complications, and survival. We measured cost-effectiveness with the incremental cost-effectiveness ratio (ICER), with ICERs under $100 000 per quality-adjusted life-year (QALY) considered cost effective. One-way and probabilistic sensitivity analyses were used to test model uncertainty.

resultsCompared to standard of care, CAR-T therapy increased overall cost by $528 200 and improved effectiveness by 8.18 QALYs, resulting in an ICER of $64 600/QALY. The model was sensitive to assumptions about long-term CAR-T survival, the complete remission rate of CAR-T patients, and the health utility of long-term survivors. The base model assumed a 76.0% one-year survival with CAR-T, although if this decreased to 57.8%, then CAR-T was no longer cost effective. If the complete remission rate of CAR-T recipients decreased from 81% to 56.2%, or if the health utility of disease-free survivors decreased from 0.94 to 0.66, then CAR-T was no longer cost effective. Probabilistic sensitivity analysis found that CAR-T was cost effective in 94.8% of iterations at a willingness to pay of $100 000/QALY.

conclusionCAR-T therapy may represent a cost-effective option for pediatric relapsed/refractory B-ALL, although longer follow-up of CAR-T survivors is required to confirm validity of these findings.

Indexed as

Cost-Benefit AnalysisB-LymphocytesChildDisease-Free SurvivalFemaleHumansImmunotherapy, AdoptiveMalePediatricsPrecursor Cell Lymphoblastic Leukemia-LymphomaQuality-Adjusted Life YearsReceptors, Antigen, T-CellReceptors, Antigen, T-Cell

Identifiers

PMID30551196
PMCPMC6624167
OpenAlexW2904940919

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.