Evidence map›Paper›PMID 40306910›Full record

ArticleBMJ open2025

Tremelimumab plus durvalumab versus sorafenib in first-line treatment of unresectable hepatocellular carcinoma: a cost-effectiveness analysis from the US payer perspective.

Shuqiao Cheng, Bin Li, Lanhua Tang, Shao Liu, Jian Xiao

Registry-linked trialAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03298451 (A Randomized, Open-label, Multi-center Phase III Study of Durvalumab and Tremelimumab as First-line Treatment in Patients With Advanced Hepatocellular Carcinoma), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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.

NCT03298451 phase3active not recruitingnot on this map

A Randomized, Open-label, Multi-center Phase III Study of Durvalumab and Tremelimumab as First-line Treatment in Patients With Advanced Hepatocellular Carcinoma

TypeinterventionalSponsorAstraZenecaRan2017 to 2027Enrolled1,324ConditionsHepatocellular CarcinomaArmsDurvalumab, Tremelimumab (Regimen 1), Tremelimumab (Regimen 2), Sorafenib, Durvalumab (Regimen 1)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
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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

5 authors.

Shuqiao ChengDepartment of Pharmacy, Xiangya Hospital Central South University, Changsha, Hunan, China.ORCID http://orcid.org/0000-0001-5053-0315
Bin LiDepartment of Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China.
Lanhua TangDepartment of Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China.
Shao LiuDepartment of Pharmacy, Xiangya Hospital Central South University, Changsha, Hunan, China admanoas@163.com liushao999@csu.edu.cn.
Jian XiaoDepartment of Pharmacy, Xiangya Hospital Central South University, Changsha, Hunan, China admanoas@163.com liushao999@csu.edu.cn.ORCID http://orcid.org/0000-0002-4039-306X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIn a recently published 4-year overall survival (OS) update from the phase III clinical trial named HIMALAYA (NCT03298451), single tremelimumab plus regular interval durvalumab (a regimen termed STRIDE) demonstrated significantly improved OS compared with sorafenib in the first-line setting of unresectable hepatocellular carcinoma (uHCC). Although dual immunotherapy represents a novel treatment option for uHCC, the economic implications of these high-priced drugs require further exploration. This study aimed to evaluate the cost-effectiveness of STRIDE in uHCC to inform first-line treatment decisions and help allocate medical resources most effectively.

designUsing a partitioned survival model, we conducted a cost-effectiveness analysis comparing STRIDE to sorafenib in the first-line treatment of uHCC. Clinical information was gathered from the phase III HIMALAYA trial. Costs and health state utilities data were derived from previous literature. Uncertainty of the model was assessed through one-way sensitivity analysis and probabilistic sensitivity analysis. OUTCOME MEASURES: Total costs, life years, quality-adjusted life years (QALYs), incremental QALYs and incremental cost-effectiveness ratio (ICER).

settingUS payer perspective.

participants393 participants in the STRIDE group and 389 participants in the sorafenib group who were diagnosed with uHCC and had no previous systemic treatment.

interventionsSingle-dose tremelimumab plus monthly durvalumab (STRIDE) versus sorafenib.

resultsTreatment with STRIDE provided an additional 0.51 QALYs at an incremental total cost of United States dollar ($)9812. The ICER of STRIDE was $19 239 per QALY compared with sorafenib, which falls below the willingness-to-pay threshold of $150 000 per QALY. Sensitivity analyses indicated that our results were robust to the variation ranges of key inputs.

conclusionIn this economic evaluation comparing two first-line systemic therapies for uHCC patients, STRIDE was cost-effective compared with sorafenib from a US payer perspective. Our study is the first to demonstrate that immunotherapy can provide both survival benefits and economic viability in uHCC.

Indexed as

Antibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, HepatocellularLiver NeoplasmsSorafenibClinical Trials, Phase III as TopicCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansMaleQuality-Adjusted Life YearsUnited StatesAntibodies, MonoclonalAntibodies, Monoclonal, HumanizeddurvalumabSorafenibtremelimumabDrug TherapyHEALTH ECONOMICSIMMUNOLOGY

Identifiers

PMID40306910
PMCPMC12049948

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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.