Cost-Effectiveness of the New Combination Trifluridine/Tipiracil Plus Bevacizumab for the Third-Line Treatment for Metastatic Colorectal Cancer in Italy

Recently, Prager et al 1 Prager GW Taieb J Fakih M Ciardiello F Van Cutsem E Elez E Cruz FM Wyrwicz L Stroyakovskiy D Pápai Z Poureau PG Liposits G Cremolini C Bondarenko I Modest DP Benhadji KA Amellal N Leger C Vidot L Tabernero J SUNLIGHT Investigators. Trifluridine-Tipiracil and Bevacizumab in Refractory Metastatic Colorectal Cancer. N Engl J Med. 2023; 388: 1657-1667 Crossref PubMed Scopus (13) Google Scholar have presented the results of the SUNLIGHT trial, a phase III randomized controlled trial (RCT) that have compared the combination of trifluridine/tipiracil (TFD-TPI) plus bevacizumab (combination group) versus (vs.) TFD/TPI alone (TFD/TPI group) for the treatment of metastatic colorectal cancer (mCRC) that had received no more than two previous chemotherapy regimens. The primary end point was overall survival (OS). The median OS was 10.8 months in the combination group (246 patients) and 7.5 months in the TFD/TPI group (246 patients) (HR= 0.61; 95% confidence interval [CI], 0.49 to 0.77; p< 0.001). Serious adverse events were reported in 24.8% and 31.3% in the two groups, respectively. With this background and considering the registered indications by the Regulatory Authorities that link the prescription of the different treatments to well defined patient's characteristics, line of treatment and companion drug, and considering the greatest budgetary impact of the new drugs 2 Giuliani J Bonetti A The Pharmacological Costs of First-Line Therapies in Unselected Patients With Advanced Colorectal Cancer: A Review of Published Phase III Trials. Clin Colorectal Cancer. 2016; 15: 277-284 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , we have compared the costs of the combination of TFD/TPI plus bevacizumab vs. TFD/TPI alone in third-line treatment for mCRC 1 Prager GW Taieb J Fakih M Ciardiello F Van Cutsem E Elez E Cruz FM Wyrwicz L Stroyakovskiy D Pápai Z Poureau PG Liposits G Cremolini C Bondarenko I Modest DP Benhadji KA Amellal N Leger C Vidot L Tabernero J SUNLIGHT Investigators. Trifluridine-Tipiracil and Bevacizumab in Refractory Metastatic Colorectal Cancer. N Engl J Med. 2023; 388: 1657-1667 Crossref PubMed Scopus (13) Google Scholar with the added value represented by the improvement of the clinical parameters of interest such as overall survival (OS). The aim of this paper was to assess the cost-effectiveness of the combination TFD/TPI plus bevacizumab in third-line treatment for mCRC from an Italian perpective.