ABSTRACT
OBJECTIVE：To ev aluate the economics of pembrolizumab versus first-line chemotherapy in the treatment of advanced non-small cell lung cancer with high programmed cell death protein ligand 1（PD-L1）expression from the perspective of Chinese healthcare system. METHODS ：Published KEYNOTE- 042 clinical trial data and relevant literature data were used to establish a Markov model to evaluate the economics of pembrolizumab versus first-line chemotherapy with a 20-years horizon and a 3-week cycle length ，discounting costs and utilities using a discount rate of 5％. One-way sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the stability of the model results. RESULTS ：The base-case results showed that pembrolizumab yield additional 1.62 QALYs more than first-line chemotherapy ，with an incremental cost of 54 648 yuan；the incremental cost-utility ratio was 33 686 yuan/QALY，which was lower than the willingness-to-pay threshold （WTP）in China. The results of one-way sensitivity analysis showed that the price of nivolumab ，the price of pembrolizumab and the proportion of patients who received second-line immunotherapy in first-line chemotherapy group had the greatest impact on the results. The results of probabilistic sensitivity analysis showed that the probability of pembrolizumab to be cost-effective gradually increased within the WTP of 0-140 000/QALY. When WTP was 70 892 yuan/QALY（one time of the per capita GDP of China in 2019），the probability of pembrolizumab to be cost-effective was 95％. When WTP beyond 100 000 yuan/QALY，the probability of pembrolizumab to be cost-effective was 100％. CONCLUSIONS ：Pembrolizumab has economic advantages than first-line chemotherapy in the first-line treatment of non-small cell lung cancer with high PD-L 1 expression in China.
ABSTRACT
Renal transplantation is the optimal approach to improve the quality of life and restore normal life for patients with end-stage renal diseases.With the development of medical techniques and immunosuppressants, the shortterm survival of renal graft has been significantly prolonged, whereas the long-term survival remains to be urgently solved.Renal ischemia-reperfusion injury (IRI), acute rejection, chronic renal allograft dysfunction, renal fibrosis and other factors are still the major problems affecting the survival of renal graft.Relevant researches have always been hot spots in the field of renal transplantation.Meantime, 2020 is an extraordinary year.The novel coronavirus pneumonia (COVID-19) pandemic severely affects the development of all walks of life.Researches related to renal transplantation have also sprung up.In this article, the frontier hotspots of clinical and basic studies related to renal transplantation and the COVID-19 related researches in the field of renal transplantation in China were reviewed, aiming to provide novel therapeutic ideas and strategies.
ABSTRACT
Despite the rapid development of organ transplantation technique, the long-term survival and functional maintenance of transplant organs still depend on the massive use of immunosuppressants.At present, the rejection and infection after organ transplantation remain the major problem facing transplant surgeons and recipients. The basic research in the field of organ transplantation is still steadily advancing to further explore the basic biological principle of rejection and immune tolerance, resolve multiple pathophysiological questions in the process of clinical organ transplantation and provide basic theoretical basis and clinical intervention guidance for wider and more effective application of organ transplantation.In 2020, researchers have achieved significant progresses on a wide range of basic researches of organ transplantation, such as the fundamental principle of immune response, overcoming transplantation rejection and inducing transplantation immune tolerance, etc.In this article, novel attempts and progresses upon inducing transplantation immune tolerance in 2020 were reviewed from two perspectives including inhibition of immune cell function and suppression of immune signaling pathway, and the main development direction of immunology of organ transplantation in the future was prospected.