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Table 2 Identified utility studies by line of treatment

From: Systematic review of health state utility values in metastatic non-small cell lung cancer with a focus on previously treated patients

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

  1. 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
  2. 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
  3. cStudies reported data on first-line treatment and subsequent treatment lines
  4. dPrevious treatment with systemic CHEMO or EGFR inhibitors allowed
  5. 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.
  6. 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
  7. 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