ArticleTherapeutic advances in medical oncology2025
A cost-effectiveness comparison between immunotherapy combination regimens and sunitinib for advanced renal cell carcinoma in the USA and China.
Article in Therapeutic advances in medical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Oncolytic adenovirus co-expressing IL-12 and shVEGF potentiates immune checkpoint blockade for treatment of renal cell carcinoma: in vitro, organ-on-a-chip, and in vivo evaluation.Molecular medicine (Cambridge, Mass.) · 2026Article
- Benmelstobart Plus Anlotinib Is Unlikely to Be Cost-Effective for Advanced Renal Cell Carcinoma: An Integrated Disease Burden and Cost-Effectiveness Analysis.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Immunotherapy combinations like Pembrolizumab + Axitinib and Nivolumab + Ipilimumab have survival benefits over Sunitinib in advanced renal cell carcinoma (aRCC) first-line treatment. But their cost-effectiveness in the USA and China is unclear. Objectives: To assess the cost-effectiveness of three first-line treatment regimens for untreated aRCC-Nivolumab plus Ipilimumab, Pembrolizumab plus Axitinib, and Sunitinib-from the perspective of national health service systems and indirect healthcare payers in China and the USA, with a focus on intent-to-treat (ITT) populations and International mRCC Database Consortium (IMDC) risk stratifications. Design: Decision-tree and Markov models, based on KEYNOTE-426 and CheckMate 214 trials, simulated 5-year disease progression of eligible patients. Methods: The model, constructed using TreeAge Pro 2022 (TreeAge Software, LLC, Williamstown, Massachusetts, USA), incorporated three health states: progression-free survival, progressive disease, and death. Economic parameters included direct medical costs (first-line and second-line treatments, adverse event management, monitoring), quality-adjusted life year (QALYs), and incremental cost-effectiveness ratios (ICERs). Probabilistic sensitivity analysis was performed to evaluate model uncertainty. Results: Across favorable-risk, intermediate/poor-risk IMDC subgroups, and the ITT population, Nivolumab plus Ipilimumab sequential Cabozantinib demonstrated the optimal cost-effectiveness in both countries, with ICERs below the willingness-to-pay (WTP) thresholds. It was associated with lower costs and higher QALYs compared to the other two regimens. Pembrolizumab plus Axitinib sequential Cabozantinib was more cost-effective than sunitinib sequential Cabozantinib in both regions, with ICERs also below WTP thresholds. Conclusion: In China and the USA, Nivolumab plus Ipilimumab is the most cost-effective first-line treatment for aRCC across different IMDC subgroups and the ITT population, followed by Pembrolizumab plus Axitinib, which outperforms sunitinib. These findings can guide clinical decision-making, though their generalizability is limited to China and the USA due to regional differences in drug pricing, payment systems, and market access.
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