Temporal trends of adverse events and costs of nivolumab plus ipilimumab versus sunitinib in advanced renal cell carcinoma

Future Oncol. 2022 Mar;18(10):1219-1234. doi: 10.2217/fon-2021-1109. Epub 2021 Dec 23.

Abstract

Aims: To assess grade 3/4 adverse events (AEs) and costs of first-line nivolumab plus ipilimumab versus sunitinib in advanced or metastatic renal cell carcinoma. Methods: Individual patient data from the all treated population in the CheckMate 214 trial (nivolumab plus ipilimumab, n = 547; sunitinib, n = 535) were used to calculate the number of AEs. AE unit costs were obtained from US 2017 Healthcare Cost and Utilization Project and inflated to 2020 values. Results: The proportion of patients experiencing grade 3/4 AEs decreased over time. Patients who received nivolumab plus ipilimumab had lower average per-patient all-cause grade 3/4 AE costs versus sunitinib (12-month: US$15,170 vs US$20,342; 42-month: US$19,096 vs US$27,473). Conclusion: Treatment with nivolumab plus ipilimumab was associated with lower grade 3/4 AE costs than sunitinib.

Keywords: CheckMate 214; advanced/metastatic renal cell carcinoma; adverse events; costs; nivolumab plus ipilimumab; sunitinib; temporal trends.

Plain language summary

Immunotherapy combinations are now accepted as safe and effective first-line treatment options for advanced or metastatic renal cell carcinoma. This study used patient data from the CheckMate 214 clinical trial to evaluate the temporal trends and costs related to grade 3/4 adverse events (AEs) among patients treated with nivolumab plus ipilimumab versus sunitinib. We found that the proportion of patients experiencing grade 3/4 AEs decreased over time and that patients treated with nivolumab plus ipilimumab had lower AE costs compared with those treated with sunitinib (at 42 months: US$19,096 vs US$27,473 per patient). As such, nivolumab plus ipilimumab may represent a treatment option that may reduce both the clinical and economic burden among patients with advanced or metastatic renal cell carcinoma.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / economics*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Renal Cell / drug therapy*
  • Cost Savings
  • Cost of Illness
  • Drug Costs / trends
  • Humans
  • Ipilimumab / adverse effects
  • Ipilimumab / economics
  • Ipilimumab / therapeutic use
  • Kidney Neoplasms / drug therapy*
  • Nivolumab / adverse effects
  • Nivolumab / economics
  • Nivolumab / therapeutic use
  • Sunitinib / adverse effects
  • Sunitinib / economics
  • Sunitinib / therapeutic use

Substances

  • Ipilimumab
  • Nivolumab
  • Sunitinib

Grants and funding