Evidence mapPaperPMID 41020007Full record

ArticleFrontiers in pharmacology2025

Ramucirumab plus paclitaxel as switch maintenance in patients with advanced HER2-negative gastric or gastro-oesophageal junction cancer: a cost-effectiveness analysis.

Jiefeng Luo, Zhengxiong Li, Qiong Du, Jiyong Liu

Abstract read
In one paragraph

Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Jiefeng Luo *Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China.
Zhengxiong Li *School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China.
Qiong DuDepartment of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China.
Jiyong LiuDepartment of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: The ARMANI trial demonstrated that ramucirumab plus paclitaxel (switch maintenance group) significantly prolonged progression-free survival (PFS) and overall survival in patients with advanced HER2-negative gastric cancer (GC) and gastroesophageal junction cancer (GEJC) compared to continued first-line oxaliplatin-based chemotherapy (control group). However, its cost-effectiveness remained unclear. This study aimed to evaluate its cost-effectiveness from the Chinese and United States (US) healthcare system perspective. Methods: A partitioned survival model was developed to compare the total costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) of switch maintenance group versus control group over a 10-year time horizon. Survival data were sourced from the ARMANI trial. Cost and utility were derived from open-access databases and published literature. The robustness of the results was verified through one-way sensitivity analysis and probabilistic sensitivity analysis (PSA). Additionally, subgroup analysis and scenario analysis were conducted. Results: The switch maintenance group yielded incremental gains of 0.15 QALYs in China and 0.16 QALYs in the US, with corresponding incremental costs of $56,738.32 and $185,250.55, resulting in ICERs of $373,219.84/QALY and $1,193,220.74/QALY, respectively. For the PD-L1 CPS ≥5 subgroup, incremental QALYs increased to 0.24 and 0.25, with incremental costs rising to $62,741.24 and $206,107.13, yielding ICERs of $266,259.94/QALY and $835,740.90/QALY, respectively. One-way sensitivity analysis revealed that the utility of PFS, the price of ramucirumab, and patient body weight were the most influential factors on the ICER, with consistent results observed from both Chinese and US perspectives. To be cost-effective in a 50% of chance, ramucirumab would need to reduce its price to 14.2% of the original price ($0.743 per mg) in China and 13.92% ($2.088 per mg) in the US, respectively. Conclusion: Ramucirumab plus paclitaxel is unlikely to be cost-effective compared to continuing oxaliplatin-based chemotherapy for patients with advanced HER2-negative GC or GEJC in China and US.

Indexed as

cost-effectivenessgastric cancergastro-oesophageal junction cancerpaclitaxelramucirumab

Identifiers

PMID41020007
PMCPMC12463587

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.