Journal Article Ppublish
PubMed: 42497525 DOI: 10.1016/j.lungcan.2026.109549
Impact of immunotherapy on overall survival and healthcare costs in advanced/metastatic lung cancer: A real-world study in France.
Lung Cancer 219:109549
Authors: Adrien Rousseau, Astrid Foix-Colonier, Joël Luu, Stéphanie Foulon, Benjamin Besse, V Valentine Laizet, Khalil-Jonathan Jewiti-Rigondza, Alaeddine Sidhom, Nahla Nacef, Aline Gauthier, Monia Ezzalfani, Julia Bonastre
Affiliations
- Paris-Saclay University, Gustave Roussy, Department of Cancer Medicine, Thoracic Group and International Center for Thoracic Cancers (CICT), 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
- Amaris Consulting, 13 Impasse Serge Reggiani, 44815 Saint-Herblain, France.
- Inserm, Oncostat U1018, labeled Ligue Contre le Cancer, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France; Paris-Saclay University, Gustave Roussy, Biostatistics and Epidemiology Department, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
- Paris-Saclay University, Gustave Roussy, Department of Cancer Medicine, Thoracic Group and International Center for Thoracic Cancers (CICT), 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
- Amaris Consulting, 360 Rue Saint-Jacques, Montréal, QC H2Y 2N1, Canada.
- Amaris Consulting, 7 Rue de Châteaudun, 75009 Paris, France.
- Amaris Consulting, Carrer de Vilamarí, 86, Eixample, 08015 Barcelona, Spain.
- Amaris Consulting, Technopole El Ghazala Route de Raoued Km 3.5 Ariana 2088, Tunisia.
Abstract
INTRODUCTION
While immunotherapies have shown a substantial overall survival (OS) benefit in clinical trials, their effectiveness and costs should be assessed in real-world setting. This study aims to assess OS and healthcare costs in advanced/metastatic lung cancer patients treated or not with immunotherapy in real-world setting.
METHODS
We performed a retrospective analysis using the French Health Data System from 2010 to 2020. Patients treated with immunotherapy for advanced/metastatic lung cancer between 2017 and 2020 were included in the IMMUNO cohort. We used two control cohorts (ADVANCED and METASTATIC) of similar patients receiving a first systemic treatment between 2012 and 2016 (before immunotherapy reimbursement in France). Propensity scores were used to match IMMUNO patients and control patients according to immunotherapy line (IMMUNO-L1, IMMUNO-L2). Healthcare costs were estimated from the French national health insurance perspective for first-line cohorts, starting from the first systemic treatment.
RESULTS
The IMMUNO-L1 cohort comprised 15,118 patients, the IMMUNO-L2 cohort 15,935 patients, the ADVANCED cohort 47,762 patients and the METASTATIC cohort 40,137 patients. After matching, median OS was 14.9 months (interquartile range (IQR): 4.5-43.9) in IMMUNO-L1 vs 7.5 months (IQR: 3.3-15.9) and 7.4 months (3.4-14.5) in IMMUNO-L1 and METASTATIC-L1 respectively. The average monthly cost was €8,801 [95 %CI: 8,684-8,917] in IMMUNO-L1, €4,205 [4,137-4,273] in ADVANCED-L1 and €4,314 [4,250-4,378] in METASTATIC-L1. The mean cumulated healthcare cost per patient was €57,561 [95 %CI: 56,707-58,414] in IMMUNO-L1, €14,399 [14,182-14,617] in ADVANCED-L1 and €15,121 [14,904-15,338] in METASTATIC-L1.
CONCLUSION
Lung cancer patients treated with immunotherapy show better real-world survival outcomes at a higher cost than standard historical chemotherapy regimens. However, the survival benefit of immunotherapy appears lower in routine practice than in clinical trials.
MeSH
Health Care Costs, Lung, Neoplasms, Immunotherapy, Lung Neoplasms, Therapeutics