Evidence map›Paper›PMID 35727476›Full record

ArticleAdvances in therapy2022

Cost-Effectiveness of KTE-X19 for Adults with Relapsed/Refractory B-Cell Acute Lymphoblastic Leukemia in the United States.

Bijal D Shah, Nathaniel J Smith, Chaoling Feng, Sushanth Jeyakumar, Jean-Gabriel Castaigne, Imi Faghmous, Behzad Kharabi Masouleh, Daniel C Malone, Michael R Bishop

Registry-linked trialOpen access · hybridAbstract read
In one paragraph

Article in Advances in therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02614066 (A Phase 1/2 Multi-Center Study Evaluating the Safety and Efficacy of KTE-X19 in Adult Subjects With Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% 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.

NCT02614066 phase1 / phase2completednot on this map

A Phase 1/2 Multi-Center Study Evaluating the Safety and Efficacy of KTE-X19 in Adult Subjects With Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia (r/r ALL) (ZUMA-3)

TypeinterventionalSponsorKite, A Gilead CompanyRan2016 to 2023Enrolled125ConditionsRelapsed/Refractory B-precursor Acute Lymphoblastic LeukemiaArmsbrexucabtagene autoleucel, Cyclophosphamide, Fludarabine
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Bijal D ShahMoffitt Cancer Center, Tampa, FL, USA.
Nathaniel J SmithMaple Health Group, LLC, 1740 Broadway, 15th Floor, New York, NY, 10019, USA. nate.smith@maplehealthgroup.com.
Chaoling FengKite, A Gilead Company, Santa Monica, CA, USA.
Sushanth JeyakumarMaple Health Group, LLC, 1740 Broadway, 15th Floor, New York, NY, 10019, USA.
Jean-Gabriel CastaigneKite, A Gilead Company, Uxbridge, UK.
Imi FaghmousKite, A Gilead Company, Uxbridge, UK.
Behzad Kharabi MasoulehKite, A Gilead Company, Santa Monica, CA, USA.
Daniel C MaloneUniversity of Utah, Salt Lake City, UT, USA.
Michael R BishopThe David Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago, IL, USA.
Gilead Sciences (United Kingdom) · GBMoffitt Cancer Center · USUniversity of Chicago · USUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite currently available treatments for adults with relapsed/refractory acute lymphoblastic leukemia (R/R ALL), survival outcomes remain poor, highlighting the need for new therapeutic strategies. This study estimates the cost-effectiveness of KTE-X19 to treat adults with R/R ALL from a US payer perspective.

methodsThe model had two components: a decision-tree, where pre-infusion costs for patients who ultimately did not receive KTE-X19 are accounted for, followed by a partitioned survival analysis, where all KTE-X19 infused patients would enter the three-state (pre-progression, progressed disease, death) model. Comparators included current standard of care treatments, i.e., blinatumomab (BLIN), inotuzumab ozogamicin (INO), and salvage chemotherapy (CHEMO). Both standard parametric and mixture cure models were used to model survival. Efficacy, safety, healthcare resource utilization, and health state utility inputs were derived from the ZUMA-3 trial (NCT02614066) and literature. Cost inputs were derived from literature or publicly available sources. Outcomes and costs were discounted 3% annually. Results of KTE-X19 versus comparators are reported as total and incremental life-years (LYs), quality-adjusted life-years (QALYs), costs, and resulting incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses (PSA) and key scenario analyses were also performed.

resultsIn the base case, incremental QALYs for KTE-X19 were 2.44, 3.26, and 4.61 versus BLIN, INO, and CHEMO, respectively. Incremental costs were $50,913, $251,532, and $432,027, respectively, resulting in ICERs of $20,843/QALY (versus BLIN), $77,271/QALY (versus INO), and $93,768/QALY (versus CHEMO). Deterministic sensitivity analysis results were most sensitive to subsequent allogeneic stem cell transplant rates and post-progression utilities. PSA found that KTE-X19 is 78.4%, 74.0%, and 75.4% likely to be cost-effective versus BLIN, INO, and CHEMO, respectively. Across most scenarios, at a willingness-to-pay (WTP) threshold of $150,000/QALY, KTE-X19 was cost-effective versus all treatments.

conclusionsCompared to current options for adults with R/R ALL, KTE-X19 is cost-effective, driven primarily by improved survival.

Indexed as

Lymphoma, B-CellPrecursor Cell Lymphoblastic Leukemia-LymphomaReceptors, Chimeric AntigenAdultClinical Trials as TopicCost-Benefit AnalysisHumansImmunotherapy, AdoptiveInotuzumab OzogamicinQuality-Adjusted Life YearsUnited Statesbrexucabtagene autoleucelInotuzumab OzogamicinReceptors, Chimeric AntigenB-CellBrexucabtagene autoleucelCD-19 antigensChimeric antigen receptor T-cellCost-effectiveness analysisEconomic evaluationKTE-X19LeukemiaRelapsed or refractory acute lymphoblastic leukemia

Identifiers

PMID35727476
PMCPMC9309154
OpenAlexW4283208488

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.