Estimation of Health-Related Utilities for 177Lu-DOTATATE in GEP-NET Patients Using Utilities Mapped from EORTC QLQ-C30 to EQ-5D-3L and QLU-C10D Utilities

Abstract

Background Gastroenteropancreatic neuroendocrine tumours (GEP-NET) are a rare, life-threatening type of cancer. The survival benefit of 177 Lu-DOTATATE has been demonstrated in GEP-NET patients. Health technology assessment bodies require data on health-related utility impacts of treatment. A cancer-specific instrument, EORTC QLQ-C30, was used to collect the data for 177 Lu-DOTATATE within clinical studies, but utility-based instruments were not included. Objective The main aim of this study was to compare EQ-5D-3L and QLU-C10D utilities obtained from EORTC QLQ-C30 using two different approaches. A secondary aim was to analyse the EQ-5D-3L and QLU-C10D utilities of patients treated with 177 Lu-DOTATATE versus best supportive care. A supplementary aim was to evaluate the effect of 177 Lu-DOTATATE on patients' health-related utility over time. Methods Three datasets were used for the analysis. NETTER-1 is a clinical trial, whilst ERASMUS and Guy's and St. Thomas (GStT) are real-world datasets. Two mapping algorithms (response mapping and ordinary least square regression) were applied to generate EQ-5D-3L utilities from EORTC QLQ-C30. An algorithm was used to obtain QLU-C10D utilities from EORTC QLQ-C30. Results In all studies, EQ-5D-3L utilities were higher than QLU-C10D utilities at most time points measured, although the magnitude of the differences was small. In NETTER-1, EQ-5D-3L and QLU-C10D utilities were higher in the 177 Lu-DOTATATE arm compared with the octreotide long-acting release (LAR) arm, overall and pre-progression. In all studies, patients' health-related utilities seem to be maintained over time. Conclusion There were small differences between EQ-5D-3L and QLU-C10D utilities, but these did not translate to relative differences over time or between groups. In NETTER-1, patients in the 177 Lu-DOTATATE arm had higher health-related utilities than patients in the octreotide LAR arm. Health-related utility may at least remain maintained in patients with GEP-NET receiving 177 Lu-DOTATATE.

Lutetium (¹⁷⁷Lu) Oxodotreotide (Lutathera)

“…Patients were not eligible if they were diagnosed with NETs of other origins. 5 Patients in the NETTER-R study had a mean age of 58 years (||||||||; range, 28.0 to 89.0 years).…”

“…Of patients with Eastern Cooperative Oncology Group Performance Status (ECOG PS) assessed, most patients had an ECOG PS of 0 (||||) or 1 (||||). 5 Most patients had received prior anticancer treatments (92%) and had received a mean 4.7 prior or concomitant therapies. Of patients, 91% had received prior anticancer therapy for NET disease; patients mostly received chemotherapy (||||), radiotherapy (||||), or other therapies (91%).…”

“…Of patients, 91% had received prior anticancer therapy for NET disease; patients mostly received chemotherapy (||||), radiotherapy (||||), or other therapies (91%). 5 Seventy percent had received prior somatostatins and analogues, mainly lanreotide or octreotide (||| ||||). Thirty-eight percent had received prior tyrosine kinase inhibitors (TKIs), mainly everolimus (33%) or sunitinib (20%).…”

“…Of patients with ECOG PS assessed, most patients had an ECOG PS of 0 (|||) or 1 (|||). 5 Most patients had received prior anticancer treatments (92%), with a mean 4.7 prior or concomitant therapies. Prior anticancer therapy specifically for pNET disease was received by 91% of patients; these patients received mainly chemotherapy (|||), radiotherapy (|||), or other therapies (91%).…”

“…Of patients with ECOG PS assessed, most had an ECOG PS of 0 (|||) or 1 (|||). 5 Most patients completed a standard regimen of 177 Lu oxodotreotide.…”