Role of PET/CT in improving the cost effectiveness of nimotuzumab in nasopharyngeal carcinoma

Abstract

Summary Objective This study aims to use the maximum standardised uptake value (SUV max ) of 18F-fluorodeoxyglucose positron emission tomography to improve the cost effectiveness of nimotuzumab (NTZ) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Methods Two hundred and forty-eigh patients with LA-NPC, who met the inclusion criteria, were recruited from January 2012 to June 2019. The survival differences and independent factors were assessed using the Kaplan-Meier method and by Cox proportional hazards regression analysis. A cost effectiveness analysis was performed. Results The optimal cut-off value for SUV max was 12.92. Multivariable analysis indicated a prognostic significance of overall survival (OS) for the NTZ treatment (p = 0.023) and SUV max (p = 0.014). The exploratory subgroup survival analysis revealed that LA-NPC patients with SUV max > 12.92 treated with concurrent chemoradiotherapy (CCRT) and NTZ had a significantly improved 3-year OS compared to patients treated with CCRT alone (96.2 vs 73.2%, p = 0.047). Furthermore, the treatment cost for NTZ was $6,317.61. This incurred an additional cost of $274.68 for every 1% increase in OS. Conclusions For patients with LA-NPC with SUV max > 12.92, the addition of NTZ to CCRT can improve OS and is cost effective.