Background
Methods
Study design and search strategy
Characteristic | Inclusion criteria | Exclusion criteria |
---|---|---|
Population | Adult patients (aged ≥16 years) Locally advanced NSCLC or mNSCLC, second/subsequent line Locally advanced or metastatic NSCLC, line unspecified | Population not of interest, e.g. • in vitro data • animal data • mixed adult/child population or child population • mixed disease populations without mNSCLC data reported separately • not disease of interest • 1 L mNSCLC data (treatment-naïve or maintenance first-line treatment) were excluded but taggeda |
Interventions/comparators | Not relevant for QoL SR selection. Intervention-specific utility data were noted as such during data extraction | N/A |
Outcomes | For mNSCLC patients: • individual (patient or caregiver) derived mean or median health state utilities from indirect generic HRQoL measure (EQ-5D (-3 L and -5 L), SF-6D, HUI2, HUI3, AQoL, QWB, 15D, MAUI) or direct valuation by TTO, SG or EQ-VAS • SF-36 or SF-12 • general public valuations of vignettes using TTO or SG For NSCLC or wider population: • disutilities or decrements for AEsb or progressive disease | No outcome of interest: • expert or healthcare provider (doctor, nurse) valuations of utilities • utilities not relating to a specific health state |
Study design | RCTs, non-RCTs, observational data | Study design not of interest: • case reports, n = 1 before-and-after studies • PK/PD study only • (Non-systematic) reviews • SRs/NMAsc |
Date limits | Unlimited | – |
Child citation | Citation linked to another paper but with unique data | Child citation or sub-study with no unique data, determined at first or second pass |
Duplicate citation | Duplicate/copy | |
Publication type | Publication type not of interest e.g. editorials, commentaries, letters, notes, press articles, unless relevant data has been published in a letter, for example, that does not appear elsewhere in the literature Confidential reports where unable to use report, or Hayes Inc. reports requiring purchase | |
Language | English or French Any foreign language paper with an English abstract were included if sufficient information is present in the English abstract to ensure the eligibility criteria are met | Full text in language other than English or French with no English abstract or no abstract; or insufficient information in English language abstract of foreign language full paper to assess eligibility |
Author, year, country | Line of treatment | Health state | Instrument | Treatment |
---|---|---|---|---|
First linea | ||||
Handorf 2012 USA [70] | 1 L | Stage IV adenocarcinoma SDis, PD, SDis+AEs (neutropenia, pneumothorax, haemorrhage, thrombocytopenia, thrombosis) | Expert opinion estimates,b published sources | NTS |
Nafees 2016 Multinational and UK [68] | 1 L | Metastatic NSCLC common grade III/IV toxicities (neutropenia, febrile neutropenia, fatigue, nausea and vomiting, diarrhea, hair loss, rash), bleeding, hypertension | TTO (general public) | NTS |
≥ First linec | ||||
Chevalier 2013 France and nine other countries [38] | 1 L, 2 L, 3/4 L and BSC | Advanced/metastatic NSCLC 1 L, 2 L, 3/4 L PF and PD | EQ-5D | NTS |
Chouaid 2013 Multinational [39] | 1 L 55.1% 2 L 24.7% 3/4 L 17.9% BSC 2.3% | Advanced/metastatic NSCLC 1 L, 2 L, 3/4 L, BSC and mixed line PF and PD | EQ-5D, EQ-VAS | NTS |
Iyer 2013 France, Germany [46] | 1 L 52% 2 LL 48% | Advanced/metastatic NSCLC | EQ-5D | NTS |
Second line | ||||
Blackhall 2014 Multinational [41] | 2 L after progression on platinum-based 1 L therapy | Locally advanced/metastatic ALK+ NSCLC BL and treatment-specific utilities (not PSS) | EQ-5D EQ-VAS | CRZ PEM DOC |
Huang 2016 Worldwide [45] | 2 L after platinum-based therapy | Advanced PD-L1+ NSCLC NTS PF, PD NTS time to death | EQ-5D | PEMB DOC |
Langley 2013 UK, Australia [48] | 2 Ld | Treatment-specific stage IV NSCLC with BM at BL and after certain time points on treatment | EQ-5D | OSC WBRT + OSC |
Nafees 2008 UK [69] | 2 L | Metastatic NSCLC PD, RES, SDis, common grade III/IV toxicities (neutropenia, febrile neutropenia, fatigue, nausea and vomiting, diarrhea, hair loss, rash) | SG (general public) | NTS |
Novello 2015 Multinational [49] | 2 L | Stage III/IV recurrent NSCLC (SQ and NSQ) treatment-specific at BL and certain time points on treatment (≤ 30 weeks) | EQ-5D, EQ-VAS | NIN + DOC PLA + DOC |
Reck 2015 Multinational [50] | 2 L | Advanced SQ NSCLC treatment-specific at BL reported. Collected also for up to 1 year but values NR in abstract | EQ-5D, EQ-VAS | NIVO DOC |
Rudell 2016 USA, Canada, Hong Kong, Italy, Japan, Republic of Korea, Spain, Taiwan [57] | 2 L | Advanced EGFR+ NSCLC, treatment-specific at BL and 36 weeks on OSI | EQ-VAS | OSI |
Schuette 2012 Germany, Austria [51] | 2 L | Stage III/IV NSCLC treatment-specific at BL, 6 weeks (second cycle) and sixth cycle | EQ-5D EQ-VAS | PEM |
Vargas 2009 Mexico [72] | 2 L after previous CHEMO | NSCLC, stage NR (assumed advanced), treatment-specific not PSS | Global QoL index | ERL Taxanes |
≥ Second line | ||||
Chen 2010 UK/multinational [64] | 2 L, 3 L and BSC | Stage IIIb/IV EGFR+ NSCLC treatment-specific (not PSS) On/after DOC 2 L On/after PEM 2 L On ERL 3 L BSC | SG (general public) | DOC PEM ERL BSC |
Griebsch 2014 Multinational [37] | 2LLe and treatment-naïve | Stage IIIb with pleural effusion or stage IV NSCLC adenocarcinoma treatment-specific and NTS effect of progression | EQ-5D, EQ-VAS | AFA BSC CIS/PEM |
Hirsh 2013 Multinational [40] | 2LLf | Stage IIIb/IV NSCLC BL and treatment-specific on oral AFA 50 mg q.d. + BSC or PLA + BSC | EQ-5D | AFA + BSC PLA + BSC |
Stewart 2015 Canada [56] | Targeted therapy 84% 3LL 25% RCT 22% | Metastatic EGFR+ NSCLC, all patients not PSS PR/SDis EGFR TKI RES CHEMO RES GEF RES ERL RES OSI PD EGFR TKI | EQ-5D-3 L | GEF ERL OSI |
Schwartzberg 2015 USA, Canada [60] | 2 LL | Squamous and non-squamous stage IIIb/IV NSCLC treatment-specific weeks 6–30 Treatment-specific PR, SDis and PD weeks 6–30 | EQ-VAS | NIVO |
Treatment line not specified | ||||
Bradbury 2008 Canada [42] | Unclear | Advanced NSCLC Treatment-specific (not PSS) | EQ-5D | ERL BSC |
Chang 2016 South Korea [63] | NR | Advanced NSCLC from > 360 days before death to < 30 days before death (not PSS) | TTO (general public) | NTS |
Dansk 2016 UK [43] | NR | Synthesized advanced NSCLC PF, PD used in NICE HTAs Trial-based PF, PD Non-trial based PF, PD | EQ-5D | NTS |
Doyle 2008 UK [65] | NR | Metastatic NSCLC SDis, RES, severe symptoms (cough, dyspnoea, pain) | SG (general public) | NTS |
Grunberg 2009 USA [58] | NR | Mixed cancer population chemotherapy-related nausea, vomiting, and nausea and vomiting, of different severities | SG (patient) | CHEMO |
Grutters 2010 Netherlands [44] | NR | NSCLC with grade 3+ dyspnoea | EQ-5D | NTS |
Jang 2010 Canada [47] | NR | Stage IV NSCLC and locally advanced NSCLC | EQ-5D | NTS |
Linnet 2015 Denmark [62] | Unclear | Metastatic NSCLC second and third CHEMO cycles on oral VINO Patient and caregiver utilities reported | SF-12 | VINO |
Lloyd 2005 UK [66] | NR | Stage IV NSCLC RES, SDis i.v. treatment, SDis oral treatment, PD, end of life | SG (general public) | NTS |
Lloyd 2008 [59] | Previous CHEMO | Anaemia by haemoglobin level | General public SG, patient TTO | NTS |
Manser 2006 Australia [61] | NR | Stage IV NSCLC | AQoL | NTS |
Matza 2014 UK and Canada [67] | NR | Stage IV cancer with BMs and different types of SRE (spinal cord compression with/without paralysis, fracture of leg, fracture of rib, fracture of arm), radiation treatment (2 weeks, 5 appointments/week), radiation treatment (2 appointments), surgery to stabilize bone | TTO (general public) | NTS |
Tabberer 2006 UK [52] | NR | Advanced NSCLC RES, SDis, SDis oral treatment, SDis i.v. treatment, PD, near death, AEs (neutropenia, febrile neutropenia, nausea, diarrhoea, rash, stomatitis, neuropathy) | EQ-5D (general public) | NTS |
Trippoli 2001 Italy [53] | NR | Metastatic NSCLC | EQ-5D, EQ-VAS | NTS |
Westwood 2014 [71] | NR for other disutilities | Advanced NSCLC Disutility for anaemia and for i.v./oral treatment mode | SG NR for other disutilities | NTS ERL i.v. tx |
Yang 2014 Taiwan [54] | NR | NSCLC operable (I–IIIA) and NSCLC inoperable (IIIB/IV) | EQ-5D | NTS |
Yokoyama 2013 Japan [55] | NR | Stage IIIB/IV mixed NSCLC/SCLC with bone metastasis and SRE (pathologic fracture, radiation or surgery to bone lesion, spinal cord compression or hypercalcaemia) | EQ-5D | NTS |
Study selection
Data extraction
Quality and relevance assessment
Results
Search yields
Description of studies identified
Relevant HSUVs by line of treatment
Study | Health state | Utility valuea | Instrument | Tariff | Respondent details | HTA suitability |
---|---|---|---|---|---|---|
1st line | ||||||
Nafees 2016 [68] Metastatic NSCLCb | PD vs BL state | 0.095 | TTO | N/A | Patients (but not NSCLC patients) from the general public in UK, Australia, France, China, S. Korea, Taiwan | No |
RES no side effects vs BL | 0.773 | |||||
SDis no side effects vs BL | 0.460 | |||||
Chevalier 2013c [38] Advanced/metastatic NSCLC | 1 L PF | 0.69 (0.26) | EQ-5D | French (TTO) | Stage I–Stage III/IV PF and PD | Meets HAS requirements |
1 L PD | 0.61 (0.24) | |||||
Chouaid 2013 [39] Advanced/metastatic NSCLC | 1 L PF | 0.71 (0.24) (95% CI, 0.67–0.76) | EQ-5D-3 L | UK | At time of advanced diagnosis, mean age 64.8 years Adenocarcinoma: 65.2% Large-cell carcinoma: 6.8% SQ cell carcinoma: 17.1% Other: 9.9% Clinical stage at time of survey: IIIb: 17.9% IV: 82.1% | Meets NICE requirements |
69.31 (18.33) (95% CI, 65.9–72.8) | EQ-5D VAS | N/A | No | |||
1 L PD | 0.67 (0.2) (95% CI 0.59–0.75) | EQ-5D-3 L | UK | Meets NICE requirements | ||
58.67 (17.4) (95% CI 51.3–66.0) | EQ-5D VAS | N/A | No | |||
Iyer 2013 [46] Advanced/metastatic NSCLC | France, Germany 1 L | 0.63 (0.31) | EQ-5D | UK1 | Patients with: Adenocarcinoma: 56.3% Large-cell carcinoma: 11.8% SQ cell carcinoma: 29.3% Other: 2.5% Stage IIIb: 15.4% Stage: IV 84.6% | Meets NICE requirement |
60.8 (19.9) | EQ-5D VAS | N/A | No | |||
≥ 1st line | ||||||
Iyer 2013 [46] Advanced/metastatic NSCLC | France, Germany 1 L/2 L | 0.58 (0.35) | EQ-5D | UK | Patients with: Adenocarcinoma: 56.3% Large-cell carcinoma: 11.8% SQ cell carcinoma: 29.3% Other: 2.5% Stage IIIb: 15.4% Stage: IV 84.6% | Meets NICE and SMC requirements |
France, 1 L/2 L | 0.57 (0.41) | |||||
Germany, 1 L/2 L | 0.59 (0.31) | |||||
France, Germany 1 L/2 L | 58.0 (19.9) | EQ-5D VAS | No | |||
France, 1 L/2 L | 57.1 (21.1) | |||||
Germany, 1 L/2 L | 58.6 (19.1) | |||||
2nd line | ||||||
Blackhall 2014 [41] Advanced/metastatic ALK+ NSCLC | 2 L BL CRZ | 0.73 (0.24) | EQ-5D-3 L | NR | Multinational patients, locally advanced/metastatic ALK+ NSCLC, 2 L | Unclear as tariff NR |
2 L BL chemotherapy (PEM or DOC) | 0.70 (0.26) | |||||
2 L BL PEM | 0.73 (0.24) | |||||
2 L BL DOC | 0.67 (0.29) | |||||
2 L on CRZ | 0.82 (SE, 0.01) (95% CI, 0.79–0.85) | |||||
2 L on Chemotherapy | 0.73 (SE, 0.02) (95% CI, 0.70–0.77) | |||||
2 L on PEM | 0.74 (SE, 0.02) (95% CI, 0.70–0.79) | |||||
2 L on DOC | 0.66 (SE, 0.04) (95% CI, 0.58–0.74) | |||||
Chevalier 2013c [38] Advanced/metastatic NSCLC | 2 L PF | 0.70 (0.22) | EQ-5D | French (TTO) | Stage I–Stage III/IV PF and PD | Meets HAS requirements |
2 L PD | 0.55 (0.35) | |||||
Chouaid 2013 [39] Advanced/metastatic NSCLC | 2 L PF | 0.74 (0.18) (95% CI, 0.68–0.80) | EQ-5D-3 L | UK | At time of advanced diagnosis, mean age 64.8 years Adenocarcinoma: 65.2% Large-cell carcinoma: 6.8% SQ cell carcinoma: 17.1% Other: 9.9% Clinical stage at time of survey: IIIb: 17.9% IV: 82.1% | Meets NICE requirements |
65.0 (19.6) (95% CI, 59.2–70.8) | EQ-5D VAS | N/A | No | |||
2 L PD | 0.59 (0.34) (95% CI, 0.42–0.77) | EQ-5D-3 L | UK | Meets NICE requirements | ||
53.5 (23.3) (95% CI, 41.5–65.4) | EQ-5D VAS | N/A | No | |||
Huang 2016c [45] Advanced PD-L1+ NSCLC | 2 L PF | 0.76 (95% CI, 0.75–0.77) | EQ-5D | NR | Multinational patients with advanced NSCLC and PD-L1+ tumours in 2 L on PEMB or DOC, after platinum-based chemotherapy | Unclear as tariff NR |
2 L PD | 0.69 (95% CI, 0.66–0.71) | |||||
Advanced PD-L1+ NSCLC, 2 L, > 360 days from death | 0.81 (0.79, 0.83) | Patients with advanced NSCLC and PD-L1+ tumours in 2 L on PEMB or DOC, after platinum-based chemotherapy | ||||
Advanced PD-L1+ NSCLC, 2 L, 180–360 days from death | 0.73 (0.71, 0.75) | |||||
Advanced PD-L1+ NSCLC, 2 L, 90–180 days from death | 0.69 (0.66, 0.72) | |||||
Advanced PD-L1+ NSCLC, 2 L, 30–90 days from death | 0.60 (0.56, 0.64) | |||||
Advanced PD-L1+ NSCLC, 2 L, < 30 days from death | 0.40 (0.31, 0.48) | |||||
Iyer 2013 [46] Advanced/metastatic NSCLC | On treatment: 2 L only | 0.53 (0.38) | EQ-5D | UK | French and German patients | Meets NICE and SMC requirements |
54.9 (19.3) | EQ-5D VAS | N/A | No | |||
Langley 2013 [48] Stage IV NSCLC with brain metastases | NSCLC with BM, previous tx allowed, OSC + WBRT 0 days | 0.63 | EQ-5D | NRd | UK and Australian NSCLC patients with brain metastases | No, as VAS tariff used |
NSCLC with BM, previous tx allowed, OSC + WBRT 28 days | 0.49 | |||||
NSCLC with BM, previous tx allowed, OSC + WBRT 56 days | 0.39 | |||||
NSCLC with BM, previous tx allowed, OSC + WBRT 112 days | 0.36 | |||||
NSCLC with BM, previous tx allowed, OSC + WBRT 168 days | 0.16 | |||||
NSCLC with BM, previous tx allowed, OSC alone 0 days | 0.60 | |||||
NSCLC with BM, previous tx allowed, OSC alone 28 days | 0.49 | |||||
NSCLC with BM, previous tx allowed, OSC alone 56 days | 0.44 | |||||
NSCLC with BM, previous tx allowed, OSC alone 112 days | 0.38 | |||||
NSCLC with BM, previous tx allowed, OSC alone 168 days | 0.36 | |||||
Lloyd 2008 [59] Cancer with chemotherapy-related anaemia or fatigue | Anaemia, Hb level, ≥12.0 g/dL | 0.708 (95% CI, 0.057) | SG | N/A | General public sample from UK | No |
0.611 (95% CI, 0.112) | TTO | UK cancer patients who have recently experienced chemotherapy-related fatigue and anaemia completing vignette-based TTO | Meets NICE/SMC requirements but still vignette-based health state rather than patient rating own health | |||
Nafees 2008 [59] mNSCLC | 2 L Stable diseasee | 0.65 (SE, 0.02) | SG | N/A | 100 members of general public in UK | No, but used in multiple HTA submissions |
2 L Responding diseasef | 0.67 | |||||
2 L Response gain | 0.02 (SE, 0.01) | |||||
2 L Progressive diseaseg | 0.47 | |||||
Novello 2015 [49] Stage III/IV recurrent NSCLC (SQ and NSQ)h | 2 L NIN + DOC, before treatment (week 0) | 0.72 | EQ-5D | UK | Multinational patients with stage III/IV recurrent NSCLC (SQ and NSQ) in 2 L after chemotherapy Adenocarcinoma: 50.1% | Meets NICE/SMC requirements |
2 L NIN + DOC, after treatment (week 30) | 0.61 | |||||
2 L PLA + DOC, before treatment (week 0) | 0.72 | |||||
2 L PLA + DOC, after treatment (week 30) | 0.62 | |||||
2 L NIN + DOC, before treatment (week 0) | 69.0 | EQ-5D VAS | N/A | No | ||
2 L NIN + DOC, after treatment (week 30) | 63.2 | |||||
2 L PLA + DOC, before treatment (week 0) | 69.0 | |||||
2 L PLA + DOC, after treatment (week 30) | 63.1 | |||||
Reck 2015 [50] Advanced SQ NSCLC | 2 L NIVO at BL | 0.68 (0.208) | EQ-5D | NR | Multinational patients with advanced SQ NSCLC | Unclear as tariff NR |
2 L DOC at BL | 0.66 (0.284) | |||||
2 L NIVO at BL | 63.7 (18.2) | EQ-5D VAS | N/A | No | ||
2 L DOC at BL | 66.3 (20.5) | |||||
Rudell 2016c [57] Advanced NSCLC, EGFR+ | 2 L OSI at BL | 65.2 (20.33) | EQ-5D-5 L VAS | N/A | Multinational patients with EGFR+ advanced NSCLC, 2 L after previous TKI | No |
2 L OSI at 36 weeks | 73.7 (17.33) | |||||
Schuette 2012 [51] NSCLC Stage IIIB–IV | 2 L, PEM at BL | 0.66 (0.256) | EQ-5D | UK TTO | Austrian and German advanced/mNSCLC 2 L patients mainly after prior platinum treatment (IIIa, 6.7%; IIIb, 19.8%; IV, 73.5%) | Meets NICE/SMC requirements |
2 L, PEM at 6 weeks (2nd cycle) | 0.02 (0.214) | EQ-5D gain | ||||
2 L, PEM at 6th cycle | 0.11 (0.228) | |||||
2 L, PEM at BL | 59.3 (17.8) | EQ-5D VAS | N/A | No | ||
2 L, PEM at 6 weeks (2nd cycle) | 3.3 (12.58) | EQ-5D VAS gain | N/A | |||
2 L, PEM at 6th cycle | 12.8 (17.62) | |||||
Vargas 2009c [72] Advanced NSCLC | 2 L, on ERL | 0.81 | Global QoL index | NR | Patients with advanced NSCLC, 2 L after previous chemotherapy | No |
2 L, on taxanes | 0.62 | |||||
≥ 2nd line | ||||||
Chen 2010c [73] Advanced NSCLCd | 2 L, DOC, during treatment | 0.45i | SG | N/A | UK general public (as algorithm based on Nafees 2008 data used to calculate utilities) | Acceptable data for SMC |
2 L, DOC, after treatment | 0.57 | |||||
2 L, PEM, during treatment | 0.54 | |||||
2 L, PEM, after treatment | 0.59 | |||||
3 L, ERL, during treatment | 0.48 | |||||
BSC, during treatment | 0.47 | |||||
Chevalier 2013 [38] Advanced/metastatic NSCLC | 3/4 L PF | 0.61 (0.3) | EQ-5D | French (TTO) | Stage I–Stage III/IV PF and PD | Meets HAS requirements |
3/4 L PD | 0.42 (0.40) | |||||
Griebsch 2014 [37] Stage IIIb (with pleural effusion)/IV NSCLC adenocarcinoma (LUX-LUNG 1)j | Week 4, progression effect longitudinal model | −0.1 | EQ-5D | UK | Multinational advanced/metastatic NSCLC, 2 LL | Meets NICE requirements |
Mixed effect longitudinal model IRC | −0.056 (95% CI, − 0.083 to − 0.028) | |||||
Mixed effect longitudinal model IN | −0.065 (95% CI, − 0.092 to − 0.039) | |||||
Mixed effect longitudinal model IRC, AFA | −0.06 | |||||
Mixed effect longitudinal model IRC, BSC | −0.046 | |||||
Mixed effect longitudinal model IINV, AFA | −0.081 | |||||
Mixed effect longitudinal model IINV, BSC | −0.033 | |||||
Week 4, progression effect longitudinal model | −7.3 | EQ-5D VAS | N/A | No | ||
Mixed effect longitudinal model IRC | −3.76 (95% CI, −5.19 to −2.32) | |||||
Mixed effect longitudinal model INV | − 3.83 (95% CI, − 5.21 to − 2.44) | |||||
Mixed effect longitudinal model IRC, AFA | 3.63 | |||||
Mixed effect longitudinal model IRC, BSC | −4.11 | |||||
Mixed effect longitudinal model INV, AFA | −4.42 | |||||
Mixed effect longitudinal model INV, BSC | −2.55 | |||||
Hirsh 2013 [40] Stage IIIB/IV NSCLC | 3 LL on AFA + BSC | 0.71 | EQ-5D | UK | 98% adenocarcinoma PD following treatment lines 1–2, one of which was platinum based, plus PD after at least 12 weeks of ERL or GEF | Meets NICE requirements |
3 LL on PLA + BSC | 0.67 | |||||
3 LL on AFA + BSC | 67.4 | EQ-5D VAS | N/A | No | ||
3 LL on PLA + BSC | 65.2 | |||||
Schwartzbergc 2015 [60] Stage IIIb/IV NSCLC (SQ & NSQ) | All patients wk 6 | 1.0 (21.7) | EQ-5D VAS | N/A | Patients, 2 LL, NIVO 3 mg/kg i.v. q2w | No |
wk 12 | 5.8 (21.3) | |||||
wk 18 | 8.2 (22.3) | |||||
wk 24 | 8.2 (23.9) | |||||
wk 30 | 8.4 (29.2) | |||||
SDis wk 6 | 3.8 (19.8) | |||||
wk 12 | 6.4 (21.9) | |||||
wk 18 | 8.2 (20.9) | |||||
wk 24 | 5.2(21.9) | |||||
wk 30 | 7.2 (28.5) | |||||
PR wk 6 | 7.3 (22.4) | |||||
wk 12 | 6.6 (24.7) | |||||
wk 18 | 8.1 (27.6) | |||||
wk 24 | 18.1 (31.0) | |||||
wk 30 | 13.7 (38.2) | |||||
PD wk 6 | −5.8 (21.1) | |||||
wk 12 | −3.0 (19.8) | |||||
wk 18 | 3.9 (24.3) | |||||
wk 24 | 6.8 (12.2) | |||||
wk 30 | 5.5 (15.7) | |||||
Treatment line not specified | ||||||
Bradbury 2008c [42] Advanced NSCLC | On ERL | 0.772 | EQ-5D | NR (possibly Canadian) | Canadian patients | Potentially relevant to CADTH |
On BSC | 0.754 | |||||
Chang 2016c [63] Advanced NSCLC | > 360 days from death | 0.904 (95% CI, 0.892–0.917) | TTO | NR | General public, South Korea | No |
180–360 days from death | 0.720 (95% CI, 0.692–0.748) | |||||
90–180 days from death | 0.627 (95% CI, 0.598–0.655) | |||||
30–90 days from death | 0.379 (95% CI, 0.349–0.409) | |||||
< 30 days from death | 0.195 (95% CI, 0.172–0.218) | |||||
Dansk 2016c [43] Advanced NSCLC | Synthesized PF | Median, 0.706 Range, 0.620–0.815 | Synthesized utility across > 1 instrument type | NR | Utilities synthesized included those where respondents were patients and those where they were the general public considering a hypothetical health state | No |
Synthesized PF trial-based | Median, 0.750 Range, 0.627–0.815 | |||||
Synthesized PF non-trial-based | Median, 0.653 Range, 0.620–0.653 | |||||
Synthesized PD | Median, 0.565 Range, 0.470–0.688 | |||||
Synthesized PD trial-based | Median, 0.599 Range, 0.550–0.688 | |||||
Synthesized PD non-trial-based | Median, 0.473 Range, 0.470–0.530 | |||||
Doyle 2008 [65] Metastatic NSCLC | SDis, no additional symptoms | 0.626 | SG | N/A | General public | No |
Treatment response, no additional symptoms | 0.712 | |||||
Grunberg 2009c [58] BC/LC | Chemotherapy-induced nausea and vomiting of differing severity | Reported graphically | SG | N/A | Patients BC/LC | Meets NICE requirements |
Grutters 2010c [44] NSCLC (stage unspecified) | NSCLC with grade 3+ dyspnoea, stage unspecified | Median, 0.52 | EQ-5D-5 L | NR | Patients at an early treatment stage | No |
Jang 2010 [47] Stage IV NSCLC | Stage IV NSCLC | 0.75 (0.15) | EQ-5D | US | Patients with NSCLC attending a major Canadian cancer center outpatient clinic | No |
Linnet 2015c [62] Stage IV NSCLC on oral VINO | PCS, cycle 2 | 37.0 | SF-12 | N/A | Patients | No |
PCS, cycle 3 | 38.6 | |||||
MCS, cycle 2 | 47.7 | |||||
MCS, cycle 3 | 44.2 | |||||
PCS, cycle 2 | 52.9 | Caregivers | Potential to estimate SF-6D for caregivers to mNSCLC patients, for SMC or CADTH | |||
PCS, cycle 3 | 53.4 | |||||
MCS, cycle 2 | 46.2 | |||||
MCS, cycle 3 | 44.6 | |||||
Lloyd 2005c [66] Stage IV NSCLC | RES | 0.70 | SGk | N/A | General public | No |
SDis, oral treatment | 0.63 | |||||
SDis, i.v. treatment | 0.58 | |||||
PD | 0.42 | |||||
End of life | 0.33 | |||||
Manser 2006 [61] Stage IV NSCLC | Stage IV | Median, 0.68 (IQR, 0.54–0.82) | AQoL | Australia | Mixed stage enrolled: I, 31.5%; II, 17.4%; IIIa, 16.3%; IIIb, 7.6%; IV, 25.0% | No |
Matza 2014 [67] Stage IV cancer with bone metastases | Cancer with bone metastases and no SRE | 0.47 (0.41) | TTO | N/A | General public, UK (Edinburgh and London) | No |
0.47 (0.45) | General public, Canada (Montreal and Toronto) | |||||
0.47 (0.42) | General public, UK and Canada | |||||
Stewart 2015 [56] EGFR+ Stage IV NSCLC | PR/SDis on EGFR TKIs (GEF, ERL, AZD9291) | 0.82 (SE, 0.16) | EQ-5D-3 L | NR | Patients, eligible for or on TKI tx, 55% Asian, 45% male, median age 60, 66% never smokers. Stage IV: at diagnosis, 80% when surveyed, 100% | Unclear |
Responded to standard chemotherapy | 0.80 (SE, 0.12) | |||||
EGFR+, responded to GEF | 0.84 (SE, 0.14) | |||||
EGFR+, responded to ERL | 0.82 (SE, 0.17) | |||||
EGFR+, responded to AZD9291 | 0.83 (SE, 0.16) | |||||
EGFR+, PD during TKI treatment (GEF, ERL, AZD9291) | 0.74 (SE, 0.08) | |||||
EGFR+, all patients (PR/SDis/PD), 25% 3LL | 0.802 | |||||
Tabberer 2006 [52] Advanced NSCLC | RES | 0.49 | EQ-5D | NR | General public, UK (Cardiff, Glasgow, London and Oxford) | No |
SDis | 0.46 | |||||
SDis + oral treatment | 0.45 | |||||
SDis + i.v. treatment | 0.43 | |||||
PD | 0.22 | |||||
Near death | 0.15 | |||||
Trippoli 2001 [53] Metastatic NSCLC | Metastatic NSCLC | 0.53 (0.36) | EQ-5D | UK (TTO) | Italian patients | Meets NICE and SMC reference cases |
0.55 (0.22)l | EQ-5D VAS | N/A | No | |||
Yang 2014 [54] Stage IIIB/IV NSCLC | Stage IV inoperable, performance status 0–1 | 0.75 (0.22) | EQ-5D | Taiwan | Patients, mixed NSCLC stages: I, 0.8%; II, 0%; IIIA, 4.5%; IIIB, 16.9%; IV, 77.8% | No |
Stage IV inoperable, performance status 0–4 | 0.75 (0.22) | |||||
Yokoyama 2013c [55] Advanced NSCLC/SCLC | Stage IIIB/IV NSCLC/SCLC with bone metastasis and SRE | NR | EQ-5D | NR | Patients, advanced NSCLC, 72%, SCLC, 28% NSCLC and SCLC: IIIB, 37%; IV, 63% | No |
Relevant disutilities and decrements
Relevance | Author, year, country, referencea | Instrument and respondent | Utility type | Health state/disutility | Mean HSUV (SD) [SE] {95% CI} | HTA suitability | |
---|---|---|---|---|---|---|---|
Advanced/mNSCLC | Nafees 2008, UK [69] | SG General public | UID | Stage IV NSCLC, 2 L, stable disease | Does not meet HTA body reference case as vignette-based utility completed by general public respondents. Has been used in multiple HTA submissions, however. Specifically 2 L and UK, good sample size (n=100) and measure of dispersion available. | ||
+ Diarrhoea | 0.61 | ||||||
+ Fatigue | 0.58 | ||||||
+ Febrile neutropenia | 0.56 | ||||||
+ Hair loss | 0.61 | ||||||
+ Nausea/vomiting | 0.61 | ||||||
+ Neutropenia | 0.56 | ||||||
+ Rash | 0.62 | ||||||
Stage IV NSCLC, 2 L, responding disease | |||||||
+ Diarrhoea | 0.63 | ||||||
+ Fatigue | 0.60 | ||||||
+ Febrile neutropenia | 0.58 | ||||||
+ Hair loss | 0.63 | ||||||
+ Nausea/vomiting | 0.62 | ||||||
+ Neutropenia | 0.58 | ||||||
+ Rash | 0.64 | ||||||
D | Stage IV NSCLC, 2 L, moving from stable to progressive | −0.18 [0.022] | |||||
Neutropenia | −0.09 [0.015] | ||||||
Febrile neutropenia | −0.09 [0.016] | ||||||
Fatigue | −0.07 [0.018] | ||||||
Nausea and vomiting | −0.05 [0.016] | ||||||
Diarrhoea | −0.05 [0.016] | ||||||
Hair loss | −0.04 [0.015] | ||||||
Rash | −0.03 [0.012] | ||||||
Response gain | 0.02 [0.007] | ||||||
Tabberer 2006, UK [52] | EQ-5D (tariff NR but likely UK TTO tariff as UK sample) General public | D | Compared with stable disease (advanced NSCLC, line not specified) | Not suitable as general public respondents, line of treatment not specified, and no measure of dispersion reported. Good sample size, however (n=154) and Nafees et al. 2008 in 2 L does not provide disutilities for neuropathy or stomatitis so these values from Tabberer et al. may be the best available. | |||
Febrile neutropenia | −0.27 | ||||||
Rash | −0.06 | ||||||
Neuropathy | −0.15 | ||||||
Neutropenia | −0.14 | ||||||
Nausea | −0.14 | ||||||
Stomatitis | −0.14 | ||||||
Diarrhoea | −0.13 | ||||||
Doyle 2008, UK [65] | SG General public | UID | Metastatic NSCLC, line not specified, SDis no additional symptoms | Does not meet reference case as general public respondents. However, these are the only disutilities for severe symptoms for cough, dyspnoea and pain in mNSCLC, so are best option in spite of not meeting HTA derivation method preferences (n=101) | |||
+ Cough | 0.58 | ||||||
+ Dyspnoea | 0.58 | ||||||
+ Pain | 0.56 | ||||||
+ Cough, dyspnoea and pain | 0.46 | ||||||
D | Cough | −0.05 [0.011] | |||||
Dyspnoea | −0.05 [0.012] | ||||||
Pain | −0.07 [0.012] | ||||||
Cough, dyspnoea and painc |
− 0.17
b
| ||||||
Responding disease gain vs SDis | 0.09 [0.015] | As line not specified, data from Nafees et al. 2008 should be used in preference. | |||||
Handorf 2012, USA [70] | Expert opinion | UID | Stage IV NSCLC adenocarcinoma (1 L SDis) | ||||
+ neutropenia | 0.67 | Does not meet reference case as expert opinion-derived. This AE is covered by Nafees et al. 2008, which uses a better derivation method than expert opinion. | |||||
+ pneumothorax | 0.63 | Does not meet reference case as expert opinion-derived, but these are the only estimates for these AE health states. SDis estimate was 0.670 (oral therapy) and 0.653 (i.v. chemotherapy) for disutility calculation. | |||||
+ haemorrhage | 0.63 | ||||||
+ thrombocytopenia | 0.65 | ||||||
+ thrombosis | 0.56 | ||||||
Earlier stage NSCLC (curative intent) | Grutters 2010, country NR [44] | EQ-5D-5 L (tariff NR) Patients | UID | NSCLC, curative intent stage, line not specified, grade III+ dyspnoea | 0.52 (median) | Patient-derived EQ-5D but tariff and measure of dispersion NR. Only source of grade III+ dyspnea. Utility for NSCLC patients without dyspnoea in this sample was 0.81, i.e. disutility − 0.29 | |
Advanced/mLC (NSCLC+SCLC) | Yokoyama 2013, Japan [55] | EQ-5D (tariff NR) Patients | D | Stage IIIB/IV NSCLC/SCLC with bone metastases + skeletal related event (pathologic fracture, radiation or surgery to bone lesion, spinal cord compression or hypercalcaemia) | − 0.05d | Provides NSCLC/SCLC (mixed) patient-derived EQ-5D decrement for (mixed) SREs. Data for these AEs are limited, so although this estimate is not robust (n=9 and response % low at 32%) it does provide an indication. No variability measure reported | |
Breast cancer and lung cancer | Grunberg 2009, USA [58] | SG Patients | UID | Base state: continuous nausea and vomiting | 0.53f | Nafees et al. 2008 provide data for nausea and vomiting but if different levels of nausea and vomiting need to be discerned then these utilities can be considered. Patient-derived SG but mixed lung/breast cancers. Good sample size (n=96) but no measure of dispersion. As the Copyright fee for Grunberg 2009 was high, these data are reported from Shabaruddin 2013 [79] (a previous SR that extracted the graphical data from Grunberg 2009) | |
Increment | Limited nausea and limit vomiting vs continuous nausea and vomiting | + 0.53f | |||||
Increment | Limited nausea vs continuous nausea and vomiting | + 0.55f | |||||
Increment | Limited vomiting vs continuous nausea and vomiting | + 0.50f | |||||
Advanced Cancer | Matza 2014, UK [67] | TTO General public | U | Stage IV cancer with bone metastases (no skeletal-related events) | 0.47 (0.41) | Does not meet reference case as general population respondents. However, as there are no alternative utilities for bone metastases these UK utilities could be considered for NICE or SMC. Good sample size (n=126), SD available. | |
UID | + spinal cord compression without paralysis | 0.25 (0.50) | |||||
+ spinal cord compression with paralysis | 0.13 (0.49) | ||||||
+ fracture of the leg | 0.42 (0.41) | ||||||
+ fracture of the rib | 0.44 (0.42) | ||||||
+ fracture of the arm | 0.44 (0.41) | ||||||
+ radiation treatment (2 weeks, 5 appointments/week) | 0.42 (0.42) | ||||||
+ radiation treatment (2 appointments) | 0.45 (0.41) | ||||||
+ surgery to stabilize bone | 0.40 (0.44) | ||||||
Matza 2014, Canada [67] | TTO General public | U | Stage IV cancer with bone metastases (no skeletal-related events) | 0.47 (0.45) | Does not meet reference case as general population respondents. However, as there are no alternative utilities for bone metastases these Canadian utilities could be considered for CADTH. Reasonable sample size (n=61), SD available. | ||
UID | + spinal cord compression without paralysis | 0.25 (0.54) | |||||
+ spinal cord compression with paralysis | 0.19 (0.53) | ||||||
+ fracture of the leg | 0.40 (0.48) | ||||||
+ fracture of the rib | 0.43 (0.47) | ||||||
+ fracture of the arm | 0.43 (0.48) | ||||||
+ radiation treatment (2 weeks, 5 appointments/week) | 0.41 (0.50) | ||||||
+ radiation treatment (2 appointments) | 0.45 (0.45) | ||||||
+ surgery to stabilize bone | 0.39 (0.50) | ||||||
Matza 2014, UK and Canada [67] | TTO General public | U | Stage IV cancer with bone metastases (no skeletal-related events) | 0.47 (0.42) | Does not meet reference case as general population respondents. However, as there are no alternative utilities for bone metastases these UK+Canadian utilities could be considered for NICE, SMC or CADTH. Good sample size (n=187), SD available. | ||
UID | + spinal cord compression without paralysis | 0.25 (0.21) | |||||
+ spinal cord compression with paralysis | 0.15 (0.50) | ||||||
+ fracture of the leg | 0.41 (0.43) | ||||||
+ fracture of the rib | 0.44 (0.43) | ||||||
+ fracture of the arm | 0.43 (0.43) | ||||||
+ radiation treatment (2 weeks, 5 appointments/week) | 0.41 (0.45) | ||||||
+ radiation treatment (2 appointments) | 0.45 (0.42) | ||||||
+ surgery to stabilize bone | 0.40 (0.46) | ||||||
Matza 2014, UK [67] | TTO General public | D | Stage IV cancer with bone metastases | As above | |||
+ spinal cord compression without paralysis | −0.22 (0.31) | ||||||
+ spinal cord compression with paralysis | −0.34 (0.36) | ||||||
+ fracture of the leg | −0.05 (0.09) | ||||||
+ fracture of the rib | −0.03 (0.08) | ||||||
+ fracture of the arm | −0.03 (0.07) | ||||||
+ radiation treatment (2 weeks, 5 appointments/week) | −0.05 (0.12) | ||||||
+ radiation treatment (2 appointments) | −0.02 (0.07) | ||||||
+ surgery to stabilize bone | −0.07 (0.17) | ||||||
Matza 2014, Canada [67] | TTO General public | D | Stage IV cancer with bone metastases | As above | |||
+ spinal cord compression without paralysis | −0.22 (0.32) | ||||||
+ spinal cord compression with paralysis | −0.28 (0.30) | ||||||
+ fracture of the leg | −0.07 (0.19) | ||||||
+ fracture of the rib | −0.04 (0.17) | ||||||
+ fracture of the arm | −0.04 (0.07) | ||||||
+ radiation treatment (2 weeks, 5 appointments/week) | −0.06 (0.21) | ||||||
+ radiation treatment (2 appointments) | −0.02 (0.11) | ||||||
+ surgery to stabilize bone | −0.08 (0.21) | ||||||
Matza 2014, UK and Canada [67] | TTO General public | D | Stage IV cancer with bone metastases | As above | |||
+ spinal cord compression without paralysis | −0.22 (0.31) | ||||||
+ spinal cord compression with paralysis | −0.32 (0.34) | ||||||
+ fracture of the leg | −0.06 (0.13) | ||||||
+ fracture of the rib | −0.03 (0.12) | ||||||
+ fracture of the arm | −0.04 (0.11) | ||||||
+ radiation treatment (2 weeks, 5 appointments/week) | −0.06 (0.15) | ||||||
+ radiation treatment (2 appointments) | −0.02 (0.08) | ||||||
+ surgery to stabilize bone | −0.07 (0.18) | ||||||
Cancer, unclear stage | Lloyd 2008, UK [59] | SG General public | UID | Anaemia associated with cancer treatment | Does not meet reference case as general population sample respondent for SG exercise. | ||
Haemoglobin level (g/dL) | 7.0–8.0 | 0.58 {0.067} | |||||
8.0–9.0 | 0.61 {0.064} | ||||||
9.0–10.0 | 0.64 {0.060} | ||||||
10.0–10.5 | 0.64 {0.062} | ||||||
10.5–11.0 | 0.66 {0.061} | ||||||
11.0–12.0 | 0.70 {0.056} | ||||||
>12.0 | 0.71 {0.057} | ||||||
VAS General public | UID | Haemoglobin level (g/dL) | 7.0–8.0 | 16.9 {2.6} | |||
8.0–9.0 | 22.3 {3.0} | ||||||
9.0–10.0 | 27.6 {2.9} | ||||||
10.0–10.5 | 32.9 {3.4} | ||||||
10.5–11.0 | 38.8 {3.6} | ||||||
11.0–12.0 | 45.9 {4.2} | ||||||
>12.0 | 51.2 {4.3} | ||||||
TTO Cancer patients with recent experience of chemotherapy-related anaemia or fatigue | UID | Haemoglobin level (g/dL) | 7.0–8.0 | 0.30 {0.127} | |||
8.0–9.0 | 0.36 {0.126} | ||||||
9.0–10.0 | 0.41 {0.125} | ||||||
10.0–10.5 | 0.45 {0.122} | ||||||
10.5–11.0 | 0.45 {0.111} | ||||||
11.0–12.0 | 0.55 {0.105} | ||||||
>12.0 | 0.61 {0.112} | ||||||
U | Own current health | 0.85 {0.034} | |||||
EQ-5D current health | 0.87 {0.076} | ||||||
VAS Cancer patients with recent experience of chemotherapy-related anaemia or fatigue | UID | Haemoglobin level (g/dL) | 7.0–8.0 | 21.7 {5.7} | |||
8.0–9.0 | 32.4 {6.6} | ||||||
9.0–10.0 | 34.2 {6.7} | ||||||
10.0–10.5 | 41.9 {6.6} | ||||||
10.5–11.0 | 44.7 {6.6} | ||||||
11.0–12.0 | 52.2 {6.8} | ||||||
>12.0 | 62.4 {7.9} | ||||||
U | Own current health | 87.6 {4.9} | |||||
EQ-5D current health | 84.2 {4.57} | ||||||
NR | Westwood 2014, NR [71] | NR | D | Anaemia | 0.073 [0.018] | Disutilities for anaemia and treatment mode have been used in previous NICE submissions. However, there is no information concerning their derivation. | |
2 L NSCLC | Oral therapy (ERL) | 0.014 [0.012] | |||||
2 L NSCLC | i.v. therapy | 0.043 [0.020] | |||||
Patients without NSCLC 1 L setting | Nafees 2016, Multinational and UK [68]g | TTO Patients (but not NSCLC patients) from the general public in UK, Australia, France, China, S. Korea, Taiwan | D | Bleeding vs BL (stable no side effects) | −0.25 | No | |
Hypertension vs BL (stable no side effects) | −0.03 | ||||||
UID | Responding + bleeding vs BL | 0.534 | |||||
Responding + hypertension vs BL | 0.749 | ||||||
Stable + bleeding vs BL | 0.508 | ||||||
Stable + hypertension vs BL | 0.729 |