SynthesisBMC health services research2026
Cost-effectiveness analysis of the treatment pathway after trastuzumab treatment failure in patients with HER2-positive advanced breast cancer: a chinese health system perspective.
Synthesis in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Not yet cited in PubMed.
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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.
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.
A Randomized, Multicenter, Phase III Open-label Study of the Efficacy and Safety of Trastuzumab MCC-DM1 vs. Capecitabine + Lapatinib in Patients With HER2-Positive Locally Advanced or Metastatic Breast Cancer Who Have Received Prior Trastuzumab-Based Therapy
A Study of Pyrotinib Plus Capecitabine Versus Lapatinib Plus Capecitabine in Patients With HER2+Metastatic Breast Cancer Who Have Prior Received Anthracyclin, Taxane or Trastuzumab
A Randomised, Open-label, Parallel Controlled, Multicentre, Phase 3 Clinical Trial of Pyrotinib Plus Capecitabine Versus Lapatinib Plus Capecitabine in Patients With HER2+ Metastatic Breast Cancer:
A Phase 3, Multicenter, Randomized, Open-Label, Active-Controlled Study of DS-8201a (Trastuzumab Deruxtecan), an Anti-HER2 Antibody Drug Conjugate (ADC), Versus Ado Trastuzumab Emtansine (T-DM1) for HER2-Positive, Unresectable and/or Metastatic Breast Cancer Subjects Previously Treated With Trastuzumab and Taxane
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Authors and funding
8 authors.
Funding
Abstract
objectivesBreast cancer stands out as a prevalent and life-threatening cancer among women, ranking as the second leading cause of cancer-related fatalities globally. Trastuzumab is a commonly employed treatment for human epidermal growth factor receptor 2 (HER2) positive advanced breast cancer. Following trastuzumab treatment failure, the Chinese Society of Clinical Oncology (CSCO) recommends lapatinib with capecitabine, pyrotinib plus capecitabine, trastuzumab emtansine (T-DM1), and trastuzumab deruxtecan (T-DXd). The study aimed to evaluate the relative cost-effectiveness of four treatment approaches for advanced breast cancer with HER2 positive status in the Chinese healthcare system.
methodsThe clinical data for this study were acquired from the following clinical trials: NCT02422199, NCT03080805, NCT00829166, and NCT03529110. Survival data were reconstructed and extrapolated using fractional polynomial (FP) models, Royston-Parmar (RP) models, and standard parametric models. A partitioned survival model with a 3-week cycle length and a 10-year time horizon was developed to estimate costs, health outcomes, and incremental cost-effectiveness ratios (ICERs). The robustness of the model was tested using one-way sensitivity analysis and probabilistic sensitivity analysis.
resultsThe ICER values for pyrotinib plus capecitabine, T-DM1, and T-DXd were $59,278.37/QALY, $50,029.87/QALY, and $148,234.68/QALY, respectively, when compared to lapatinib plus capecitabine. The deterministic sensitivity analysis indicated that ICER variability was primarily driven by drug costs, patient body weight, hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), and the utilities of the progression-free (PF) and progressive disease (PD) health states. A probabilistic sensitivity analysis revealed that lapatinib's advantage produced a stable result at the willing-to-pay (WTP) threshold.
conclusionIn the context of the Chinese health system, none of the three alternative regimens-pyrotinib plus capecitabine, T-DM1, and T-DXd-demonstrated cost-effectiveness relative to lapatinib plus capecitabine at the current WTP threshold.
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