Alternative dosing strategies for immune checkpoint inhibitors to improve cost-effectiveness: a special focus on nivolumab and pembrolizumab

Immune checkpoint inhibitors have revolutionised cancer treatment by offering durable responses to many patients with solid and haematological cancers. The high prices and increasing use of immune checkpoint inhibitors put considerable strain on health-care budgets globally. This financial strain co...

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Published inThe lancet oncology Vol. 23; no. 12; pp. e552 - e561
Main Authors Malmberg, Ruben, Zietse, Michiel, Dumoulin, Daphne W, Hendrikx, Jeroen J M A, Aerts, Joachim G J V, van der Veldt, Astrid A M, Koch, Birgit C P, Sleijfer, Stefan, van Leeuwen, Roelof W F
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.12.2022
Elsevier Limited
Subjects
Antibodies, Monoclonal, Humanized
Cancer therapies
Cost analysis
Cost control
Dosage
Drug dosages
FDA approval
Hematologic Neoplasms
Humans
Immune Checkpoint Inhibitors
Immunotherapy
Lung cancer
Melanoma
Monoclonal antibodies
Nivolumab
Patients
PD-1 protein
Pembrolizumab
Pharmacodynamics
Pharmacokinetics
Targeted cancer therapy
Tumors
United States > US
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Summary:Immune checkpoint inhibitors have revolutionised cancer treatment by offering durable responses to many patients with solid and haematological cancers. The high prices and increasing use of immune checkpoint inhibitors put considerable strain on health-care budgets globally. This financial strain could jeopardise patients’ access to these anti-cancer therapies. However, substantial evidence suggests that immune checkpoint inhibitors are being administered at doses that exceed the minimum dose required for maximum anti-tumour efficacy. Therefore, investigating and implementing the most cost-effective dosing strategies for immune checkpoint inhibitors are urgently necessary. This Personal View provides an overview of existing data on immune checkpoint inhibitor pharmacology and (novel) dosing strategies for anti-PD-1 therapy with nivolumab and pembrolizumab, with a special focus on cost-effectiveness and saving potential. Furthermore, specific recommendations to guide health-care professionals are provided, through the process of prescribing, rounding, preparing, and administering nivolumab and pembrolizumab in the most practical and cost-effective way possible.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(22)00554-X