Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis
BackgroundThe COMPASSION-15 trial confirmed the safety and effectiveness of cadonilimab, a bispecific antibody targeting both programmed death 1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4), in treating human epidermal growth factor receptor 2 (HER2) negative advanced gastric or gastroesopha...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1646818/full |
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| author | Zuojuan Xiang Wei Li Qiao Xia |
| author_facet | Zuojuan Xiang Wei Li Qiao Xia |
| author_sort | Zuojuan Xiang |
| collection | DOAJ |
| description | BackgroundThe COMPASSION-15 trial confirmed the safety and effectiveness of cadonilimab, a bispecific antibody targeting both programmed death 1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4), in treating human epidermal growth factor receptor 2 (HER2) negative advanced gastric or gastroesophageal junction adenocarcinoma (G/GEJA). Notably, it demonstrated significant survival benefits even in the low programmed death ligand 1 (PD-L1) expression subgroup, overcoming the limitations of current immunotherapy. This study aims to comprehensively evaluate its cost-effectiveness.MethodsThe cost-effectiveness of cadonilimab plus chemotherapy compared to chemotherapy alone was evaluated using a partitioned survival model with a 10-year time horizon, based on data from the COMPASSION-15 trial. Incremental cost-effectiveness ratio (ICER) was estimated to ascertain the cost-effectiveness. Furthermore, subgroup analysis stratified by PD-L1 combined positive score (CPS) thresholds, as well as sensitivity and scenario analyses, were performed.ResultsThe estimated ICER value was $35,613.34/quality-adjusted life-year (QALY) for the entire cohort, $21,142.58/QALY for the high PD-L1 expression subgroup (CPS ≥5), and $45,000.62/QALY for the low PD-L1 expression subgroup (CPS <5). Only the high PD-L1 expression subgroup achieved the cost-effectiveness, as its ICER value was below the willingness-to-pay (WTP) threshold of $24,600/QALY. Sensitivity and scenario analyses demonstrated the robustness of the result.ConclusionIn China, incorporating cadonilimab with chemotherapy was found to be more cost-effective as a first-line treatment for HER2-negative advanced G/GEJA in the PD-L1 CPS ≥5 subgroup. Nevertheless, it was not cost-effective for either the entire cohort or the PD-L1 CPS <5 subgroup. These findings can provide valuable insights for future pricing strategies and healthcare decision-making. |
| format | Article |
| id | doaj-art-8c76e1cd0fd94ec289fd8cc877f0ff01 |
| institution | DOAJ |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-8c76e1cd0fd94ec289fd8cc877f0ff012025-08-20T02:46:04ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.16468181646818Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysisZuojuan XiangWei LiQiao XiaBackgroundThe COMPASSION-15 trial confirmed the safety and effectiveness of cadonilimab, a bispecific antibody targeting both programmed death 1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4), in treating human epidermal growth factor receptor 2 (HER2) negative advanced gastric or gastroesophageal junction adenocarcinoma (G/GEJA). Notably, it demonstrated significant survival benefits even in the low programmed death ligand 1 (PD-L1) expression subgroup, overcoming the limitations of current immunotherapy. This study aims to comprehensively evaluate its cost-effectiveness.MethodsThe cost-effectiveness of cadonilimab plus chemotherapy compared to chemotherapy alone was evaluated using a partitioned survival model with a 10-year time horizon, based on data from the COMPASSION-15 trial. Incremental cost-effectiveness ratio (ICER) was estimated to ascertain the cost-effectiveness. Furthermore, subgroup analysis stratified by PD-L1 combined positive score (CPS) thresholds, as well as sensitivity and scenario analyses, were performed.ResultsThe estimated ICER value was $35,613.34/quality-adjusted life-year (QALY) for the entire cohort, $21,142.58/QALY for the high PD-L1 expression subgroup (CPS ≥5), and $45,000.62/QALY for the low PD-L1 expression subgroup (CPS <5). Only the high PD-L1 expression subgroup achieved the cost-effectiveness, as its ICER value was below the willingness-to-pay (WTP) threshold of $24,600/QALY. Sensitivity and scenario analyses demonstrated the robustness of the result.ConclusionIn China, incorporating cadonilimab with chemotherapy was found to be more cost-effective as a first-line treatment for HER2-negative advanced G/GEJA in the PD-L1 CPS ≥5 subgroup. Nevertheless, it was not cost-effective for either the entire cohort or the PD-L1 CPS <5 subgroup. These findings can provide valuable insights for future pricing strategies and healthcare decision-making.https://www.frontiersin.org/articles/10.3389/fphar.2025.1646818/fullcadonilimabpartitioned survival modelcost-effectivenessPD-L1 expressiongastric or gastroesophageal junction adenocarcinoma |
| spellingShingle | Zuojuan Xiang Wei Li Qiao Xia Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis Frontiers in Pharmacology cadonilimab partitioned survival model cost-effectiveness PD-L1 expression gastric or gastroesophageal junction adenocarcinoma |
| title | Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis |
| title_full | Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis |
| title_fullStr | Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis |
| title_full_unstemmed | Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis |
| title_short | Cadonilimab in combination with chemotherapy for HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis |
| title_sort | cadonilimab in combination with chemotherapy for her2 negative advanced gastric or gastroesophageal junction adenocarcinoma a cost effectiveness analysis |
| topic | cadonilimab partitioned survival model cost-effectiveness PD-L1 expression gastric or gastroesophageal junction adenocarcinoma |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1646818/full |
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