Axicabtagene ciloleucel compared to standard of care in Canadian patients with relapsed or refractory large B-cell lymphoma: a cost-effectiveness analysis of the ZUMA-7 trial
Bibliographic record
Abstract
AIMS AND BACKGROUND: In the pivotal ZUMA-7 trial, second-line (2L) treatment with axicabtagene ciloleucel (axi-cel) had superior clinical outcomes compared to standard of care (SOC; salvage chemoimmunotherapy followed by high-dose therapy and autologous stem cell transplant in responders) in patients with large B-cell lymphoma (LBCL) who were refractory or relapsed (r/r) within 12 months of completion of frontline therapy. The aim of this analysis was to evaluate the cost-effectiveness of axi-cel compared to SOC for 2L LBCL in Canada. METHODS: A 3-health state partitioned-survival model was used to estimate the cost-effectiveness of axi-cel vs. SOC from a Canadian healthcare system perspective. Clinical outcomes were informed by ZUMA-7. The model calculated expected quality-adjusted life years (QALYs), total costs, and the incremental cost-effectiveness ratio (ICER). RESULTS: Over a lifetime horizon, the model estimated a total of 9.48 and 7.25 QALYs, and total costs of $569,168 and $337,906 for axi-cel and SOC, respectively, resulting in an ICER of $103,810/QALY. When adjusting for the substantial proportion of patients in the SOC arm who received cellular therapy as subsequent treatment, the ICER was reduced to $78,555/QALY. CONCLUSIONS: Treatment with axi-cel in 2L is a cost-effective option that addresses an important unmet clinical need for Canadian patients with r/r LBCL.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".