Table 2.
Identified utility studies by line of treatment
| 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 |
aStudies were retained, despite reporting first-line treatment only, because they reported progressive disease utility estimates similar to those seen in a second-line population, or reported AE disutility estimates from populations broader than mNSCLC
bAlthough the utilities were based on expert opinion, these were retained, as they provide disutility estimates for the adverse events pneumothorax, thrombocytopenia and thrombosis, not available elsewhere
cStudies reported data on first-line treatment and subsequent treatment lines
dPrevious treatment with systemic CHEMO or EGFR inhibitors allowed
eLux-Lung 1 trial data were in patients progressed on 1–2 lines of treatment, one of which was platinum based (could include adjuvant setting treatment line), and had PD after at least 12 wks of ERL or GEF. Lux-Lung 3 trial data were in treatment-naïve patients, so not 2 L.
fProgressed on 1–2 lines of treatment, one of which was platinum based, and had PD after at least 12 wks of ERL or GEF
Abbreviations: 1 L first line, 2 L second line, 2 LL second and subsequent line, 3LL third and subsequent line, 3/4 L third and fourth line, AE adverse event, AFA afatinib, AQoL Assessment of Quality of Life instrument, BL baseline, BM bone metastasis, BSC best supportive care, CHEMO chemotherapy, CIS cisplatin, CRZ crizotinib, DOC docetaxel, EGFR epidermal growth factor receptor, EQ-VAS EuroQol visual analogue scale, ERL erlotinib, GEF gefitinib, GEM gemcitabine, i.v. intravenous, NIN nintedanib, NIVO nivolumab, NR not reported, NSCLC non-small cell lung cancer, NSQ non-squamous, NTS not treatment-specific, OSC optimal standard care, OSI osimertinib, PD progressive disease, PEM pemetrexed, PEMB pembrolizumab, PF progression-free, PLA placebo, PR partial response, PSS progression-status-specific, q.d. once daily, QoL quality of life, RCT randomized controlled trial, RES response, SCLC small cell lung cancer, SDis stable disease, SF-12 12-item Short–Form Health Survey, SG standard gamble, SRE skeletal-related event, TKI tyrosine kinase inhibitor, TTO time trade-off, VAS visual analogue scale, VINO vinorelbine, WBRT whole-brain radiotherapy