Bevacizumab plus erlotinib prolonged patients＇ progression-free survive （PFS） versus bevacizumab alone for the maintenance treatment of none-small cell lung cancer （NSCLC） in phase III clinical trial ATLAS （Clin...Bevacizumab plus erlotinib prolonged patients＇ progression-free survive （PFS） versus bevacizumab alone for the maintenance treatment of none-small cell lung cancer （NSCLC） in phase III clinical trial ATLAS （ClinicalTrials. gov identifier NCT00257608）, which repealed a benefit outcome and acceptable side-effects, but whether its cost performance would be accepted by patients is blurry. The aim of our research is to figure out which strategy is the best option in clinic and would spread broadly. Markov Model was used to calculate incremental cost-utility radios （ICURs） and 10-year quality-adjusted life years （QALY） of both strategies. The clinical data were collected from phase III clinical trial ATLAS （ClinicalTrials. gov identifier NCT00257608）. The cost data were obtained from Chinese health care system. In the research, one-way sensitivity analysis, probabilistic sensitivity analysis （PSA） and Monte-Carlo analysis were performed to test the stability of the results. The better strategy was bevacizumab alone strategy, and the cumulative costs of both strategies were $178 648.47 and $46 445.28, respectively, and the QALY was 12.506 and 10.643, respectively. The ICUR of combined application was $70 962.53/QALY, which was much higher than 3 times of mean gross domestic product （GDP） in China, suggesting that this strategy was no economical at all. In one-way analysis, the change of willingness-to-pay could not influence the consequence. In addition, in Monte-Carlo analysis, the probability distribution of cost, effectiveness and ICUR was in normal distribution. Taken together, bevacizumab alone strategy was the better strategy in terms of cost-effectiveness.展开更多
The interplay among diverse cell populations in the tumor microenvironment contributes to tumor progression.Targeting to different cell populations might result in improved therapeutic effects on malignant tumors.Inte...The interplay among diverse cell populations in the tumor microenvironment contributes to tumor progression.Targeting to different cell populations might result in improved therapeutic effects on malignant tumors.Integrins high express on many kinds of tumor cells,and VEGF has a strong effect on tumor angiogenesis.Therefore,based on tumor cells and angiogenesis,we fabricated integrin-targeting cRGD-DOX nanoparticles and combined them with the anti-VEGF antibody bevacizumab.We evaluated the antitumor effect of this combination therapy in an integrin-overexpressing MDA-MB-231 tumor model.The cRGD-DOX nanoparticles were effectively uptake by MDA-MB-231 cells and the uptake was related to the expression of integrinin;cRGD-DOX nanoparticles showed less cytotoxic than free DOX;Bevacizumab did not show significant cytotoxicity against MDA-MB-231 cells at concentrations less than 1 mg/mL.The in vivo results showed that bevacizumab could reduce tumor interstitial fluid pressure;the combination of bevacizumab and cRGD-DOX nanoparticles showed enhanced antitumor effects compared with the corresponding single-agent treatments.These findings suggested the combination of angiogenesis antibody and integrin-targeting nanoparticle loaded with a cytotoxic drug was a promising cancer treatment regimen.展开更多
文摘Bevacizumab plus erlotinib prolonged patients＇ progression-free survive （PFS） versus bevacizumab alone for the maintenance treatment of none-small cell lung cancer （NSCLC） in phase III clinical trial ATLAS （ClinicalTrials. gov identifier NCT00257608）, which repealed a benefit outcome and acceptable side-effects, but whether its cost performance would be accepted by patients is blurry. The aim of our research is to figure out which strategy is the best option in clinic and would spread broadly. Markov Model was used to calculate incremental cost-utility radios （ICURs） and 10-year quality-adjusted life years （QALY） of both strategies. The clinical data were collected from phase III clinical trial ATLAS （ClinicalTrials. gov identifier NCT00257608）. The cost data were obtained from Chinese health care system. In the research, one-way sensitivity analysis, probabilistic sensitivity analysis （PSA） and Monte-Carlo analysis were performed to test the stability of the results. The better strategy was bevacizumab alone strategy, and the cumulative costs of both strategies were $178 648.47 and $46 445.28, respectively, and the QALY was 12.506 and 10.643, respectively. The ICUR of combined application was $70 962.53/QALY, which was much higher than 3 times of mean gross domestic product （GDP） in China, suggesting that this strategy was no economical at all. In one-way analysis, the change of willingness-to-pay could not influence the consequence. In addition, in Monte-Carlo analysis, the probability distribution of cost, effectiveness and ICUR was in normal distribution. Taken together, bevacizumab alone strategy was the better strategy in terms of cost-effectiveness.
基金National Natural Science Foundation of China(Grant No.81690264)the National Key Research and Development Program of China(Grant No.2017YFA0205600)Beijing Natural Science Foundation(Grant No.7162108)
文摘The interplay among diverse cell populations in the tumor microenvironment contributes to tumor progression.Targeting to different cell populations might result in improved therapeutic effects on malignant tumors.Integrins high express on many kinds of tumor cells,and VEGF has a strong effect on tumor angiogenesis.Therefore,based on tumor cells and angiogenesis,we fabricated integrin-targeting cRGD-DOX nanoparticles and combined them with the anti-VEGF antibody bevacizumab.We evaluated the antitumor effect of this combination therapy in an integrin-overexpressing MDA-MB-231 tumor model.The cRGD-DOX nanoparticles were effectively uptake by MDA-MB-231 cells and the uptake was related to the expression of integrinin;cRGD-DOX nanoparticles showed less cytotoxic than free DOX;Bevacizumab did not show significant cytotoxicity against MDA-MB-231 cells at concentrations less than 1 mg/mL.The in vivo results showed that bevacizumab could reduce tumor interstitial fluid pressure;the combination of bevacizumab and cRGD-DOX nanoparticles showed enhanced antitumor effects compared with the corresponding single-agent treatments.These findings suggested the combination of angiogenesis antibody and integrin-targeting nanoparticle loaded with a cytotoxic drug was a promising cancer treatment regimen.
