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Ta A, Kühne F, Laurenz M, von Eiff C, Warren S, Perdrizet J. Cost-effectiveness of PCV20 to Prevent Pneumococcal Disease in the Pediatric Population: A German Societal Perspective Analysis. Infect Dis Ther 2024; 13:1333-1358. [PMID: 38733494 PMCID: PMC11128430 DOI: 10.1007/s40121-024-00977-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/11/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Since 2009, a pneumococcal conjugate vaccine (PCV) covering 13 serotypes (PCV13) has been included by Germany's Standing Committee on Vaccinations for infants, resulting in major reductions in pneumococcal disease (PD). Higher-valent vaccines may further reduce PD burden. This cost-effectiveness analysis compared 20-valent PCV (PCV20) under a 3+1 schedule with 15-valent PCV (PCV15) and PCV13, both under 2+1 schedule, in Germany's pediatric population. METHODS A Markov model with annual cycles over a 10-year time horizon was adapted to simulate the clinical and economic impact of pediatric vaccination with PCV20 versus lower-valent PCVs in Germany. The model used PCV13 clinical effectiveness and impact studies as well as PCV7 efficacy studies for vaccine direct and indirect effect estimates. Epidemiologic, utility, and medical cost inputs were obtained from published sources. Benefits and costs were discounted at 3% from a German societal perspective. Outcomes included PD cases, deaths, costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). RESULTS In the base case, PCV20 provided greater health benefits than PCV13, averting more cases of invasive pneumococcal disease (IPD; 15,301), hospitalized and non-hospitalized pneumonia (460,197 and 472,365, respectively), otitis media (531,634), and 59,265 deaths over 10 years. This resulted in 904,854 additional QALYs and a total cost saving of €2,393,263,611, making PCV20 a dominant strategy compared with PCV13. Compared to PCV15, PCV20 was estimated to avert an additional 11,334 IPD, 704,948 pneumonia, and 441,643 otitis media cases, as well as 41,596 deaths. PCV20 was associated with a higher QALY gain and lower cost (i.e., dominance) compared with PCV15. The robustness of the results was confirmed through scenario analyses as well as deterministic and probabilistic sensitivity analyses. CONCLUSION PCV20 3+1 dominated both PCV13 2+1 and PCV15 2+1 over 10 years. Replacing lower-valent PCVs with PCV20 would result in greater clinical and economic benefits, given PCV20's broader serotype coverage.
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Affiliation(s)
- An Ta
- Cytel, London, United Kingdom
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Lytle D, Grajales Beltrán AG, Perdrizet J, Ait Yahia N, Cane A, Yarnoff B, Chapman R. Cost-effectiveness analysis of PCV20 to prevent pneumococcal disease in the Canadian pediatric population. Hum Vaccin Immunother 2023; 19:2257426. [PMID: 37771288 PMCID: PMC10543337 DOI: 10.1080/21645515.2023.2257426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
This study assessed the cost-effectiveness of the 20-valent pneumococcal conjugate vaccine (PCV20) in Canadian infants aged <2 years versus the standard of care (SoC), a 13-valent pneumococcal conjugate vaccine (PCV13), or a potential 15-valent pneumococcal conjugate vaccine (PCV15). A decision-analytic Markov model was developed to compare PCV20 with PCV13 or PCV15 in a 2 + 1 schedule over 10 years. Vaccine effect estimates (direct and indirect) across all ages were informed by PCV13 clinical effectiveness and impact studies as well as PCV7 efficacy studies. Epidemiologic, clinical, health state utilities, utility decrements, cost per event, and list price data were from Canadian sources where available. Clinical and economic outcomes related to invasive pneumococcal disease (IPD), hospitalized and non-hospitalized pneumonia, and simple and complex otitis media (OM) were calculated for each strategy. Cost-effectiveness was evaluated from the publicly funded healthcare system perspective. Over 10 years, PCV20 versus PCV13 was estimated to avert over 11,000 IPD cases, 316,000 hospitalized and non-hospitalized pneumonia cases, 335,000 simple and complex OM cases, and 15,000 deaths, resulting in cost savings of over 3.2 billion Canadian dollars (CAD) and 47,000 more quality-adjusted life years (i.e. dominant strategy). Compared with PCV15, PCV20 was estimated to result in over 1.4 billion CAD in cost savings and 21,000 more QALYs (i.e. dominant strategy). PCV20 was dominant over both PCV13 and PCV15. Given broader serotype coverage, substantial incremental benefits and cost-savings, PCV20 should be considered as a replacement for the SoC in the publicly funded Canadian infant immunization program.
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Affiliation(s)
- Derek Lytle
- Market Access, Pfizer Canada, Kirkland, QC, Canada
| | | | | | | | - Alejandro Cane
- Vaccines Medical and Scientific Affairs, North America, Pfizer Inc, Collegeville, PA, USA
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Syeed MS, Ghule P, Le LM, Veettil SK, Horn EK, Perdrizet J, Wasserman M, Thakkinstian A, Chaiyakunapruk N. Pneumococcal Vaccination in Children: A Systematic Review and Meta-Analysis of Cost-Effectiveness Studies. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:598-611. [PMID: 36328324 DOI: 10.1016/j.jval.2022.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/15/2022] [Accepted: 10/05/2022] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Pneumococcal conjugate vaccines (PCVs) have significantly reduced disease burden caused by Streptococcus pneumoniae, a leading cause of childhood morbidity and mortality globally. This systematic review and meta-analysis aimed to assess the incremental net benefit (INB) of the 13-valent PCV (PCV13) and 10-valent PCV (PCV10) in children. METHODS We performed a comprehensive search in several databases published before May 2022. Studies were included if they were cost-effectiveness or cost-utility analyses of PCV13 or PCV10 compared with no vaccination or with each other in children. Various monetary units were converted to purchasing power parity, adjusted to 2021 US dollars. The INBs were calculated and then pooled across studies stratified by country income level, perspective, and consideration of herd effects, using a random-effect model. RESULTS Seventy studies were included. When herd effects were considered, PCV13 was cost-effective compared with PCV10 from the payer perspective in both high-income countries (HICs) (INB, $103.94; 95% confidence interval, $75.28-$132.60) and low- and middle-income countries (LMICs) (INB, $53.49; 95% confidence interval, $30.42-$76.55) with statistical significance. These findings were robust across a series of sensitivity analyses. PCV13 was cost-effective compared with no vaccination across perspectives and consideration of herd effects in both HICs and LMICs, whereas findings were less consistent for PCV10. CONCLUSION PCVs were generally cost-effective compared with no vaccination in HICs and LMICs. Our study found that PCV13 was cost-effective compared with PCV10 when herd effects were considered from the payer perspective in both HICs and LMICs. The results are sensitive to the consideration of herd effects.
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Affiliation(s)
- M Sakil Syeed
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | - Priyanka Ghule
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | - Lan M Le
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | | | | | | | | | - Ammarin Thakkinstian
- The Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nathorn Chaiyakunapruk
- University of Utah College of Pharmacy, Salt Lake City, UT, USA; IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA.
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Du Y, Wang Y, Zhang T, Li J, Song H, Wang Y, Xu Y, Cui J, Yang M, Wang Z, Wu X, Wang C. Economic evaluations of 13-valent pneumococcal conjugate vaccine: a systematic review. Expert Rev Vaccines 2023; 22:193-206. [PMID: 36719062 DOI: 10.1080/14760584.2023.2173176] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Studies on economic evaluations of the 13-valent pneumococcal conjugate vaccine (PCV13) have been increasing over the last decade. No systematic reviews have synthesized the evidence of economic evaluations of the PCV13. AREAS COVERED We systematically searched the literature which published on peer-reviewed journals from January 2010 to June 2022. The literature search was conducted in the following electronic databases: PubMed, Web of Science, Embase, the Cochrane Library, CNKI, Wanfang database, VIP database. We identified 1827 records from the database search. After excluding 511 duplicates, 1314 records were screened, of which 156 records were retained for the full-text reviews. A total of 44 studies were included in the review. Among the included studies, 33 studies were economic evaluations of PCV13 among children, and 11 studies were conducted among adults. The literature search initiated in April, 2022, and updated in June 2022. EXPERT OPINION Vaccination with PCV13 was found to significantly reduce the mortality and morbidity of pneumococcal diseases and was cost-effective compared to no vaccine or several other pneumococcal vaccines (e.g. PCV10, PPV23). Future research is advised to expand economic evaluations of PCV13 combined with dynamic model to enhance methodologic rigor and prediction accuracy.
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Affiliation(s)
- Yuanze Du
- School of Public Health, Weifang Medical University, Weifang, China
| | - Yi Wang
- Division of Immunization, Center for Disease Control and Prevention, Weifang, China
| | - Ting Zhang
- School of Population Medicine & Public Health, Chinese Academy of Medical Sciences/ Peking Union Medical College, Beijing, China
| | - Juanjuan Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - Hewei Song
- School of Public Health, Weifang Medical University, Weifang, China
| | - Yuanyuan Wang
- Division of Immunization, Center for Disease Control and Prevention, Weifang, China
| | - Yifei Xu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Jingwen Cui
- School of Public Health, Weifang Medical University, Weifang, China
| | - Ming Yang
- School of Public Health, Weifang Medical University, Weifang, China
| | - Zengwu Wang
- Department of Neurosurgery, Weifang People's Hospital, Weifang, China
| | - Xiuyun Wu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Chunping Wang
- School of Public Health, Weifang Medical University, Weifang, China
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Rozenbaum MH, Perdrizet J, Li X, Wasserman MD, Grant LR, Hayford K, Farkouh RA. A Response to: Letter to the Editor Regarding 'Clinical and Economic Burden of Pneumococcal Disease Due to Serotypes Contained in Current and Investigational Pneumococcal Conjugate Vaccines in Children Under Five Years of Age'. Infect Dis Ther 2023; 12:295-298. [PMID: 36376731 PMCID: PMC9868018 DOI: 10.1007/s40121-022-00719-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mark H. Rozenbaum
- grid.487416.8Health Economics and Outcomes Research, Pfizer, Capelle aan den Ijssel, The Netherlands
| | - Johnna Perdrizet
- grid.410513.20000 0000 8800 7493Health Economics and Outcomes Research, Pfizer Inc, New York, NY USA
| | - Xiuyan Li
- grid.410513.20000 0000 8800 7493Health Economics and Outcomes Research, Pfizer Inc, New York, NY USA
| | - Matt D. Wasserman
- grid.410513.20000 0000 8800 7493Patient and Health Impact, Pfizer Inc, New York, NY USA
| | - Lindsay R. Grant
- grid.410513.20000 0000 8800 7493Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, New York, NY USA
| | - Kyla Hayford
- grid.410513.20000 0000 8800 7493Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, New York, NY USA
| | - Raymond A. Farkouh
- grid.487416.8Health Economics and Outcomes Research, Pfizer, Capelle aan den Ijssel, The Netherlands
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Wasserman MD, Perdrizet J, Grant L, Hayford K, Singh S, Saharia P, Horn EK, Farkouh RA. Clinical and Economic Burden of Pneumococcal Disease Due to Serotypes Contained in Current and Investigational Pneumococcal Conjugate Vaccines in Children Under Five Years of Age. Infect Dis Ther 2021; 10:2701-2720. [PMID: 34633639 PMCID: PMC8503717 DOI: 10.1007/s40121-021-00544-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/28/2021] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION The widespread implementation of pneumococcal conjugate vaccines (PCVs) has significantly reduced the burden of pneumococcal disease around the world. Although licensed 10-valent (PCV10) and 13-valent (PCV13) vaccines have considerably reduced mortality and morbidity, a sizeable disease burden attributable to serotypes not contained in these PCVs remains. This study aimed to estimate the annual clinical and economic burden of pneumococcal disease attributable to licensed (PCV10 and PCV13) and investigational PCVs, notably 15-valent (PCV15) and 20-valent (PCV20) vaccines, in 13 countries in children under 5 years of age. METHODS A decision-analytic model was created to aggregate total cases [inclusive of invasive pneumococcal disease (IPD), pneumonia, and otitis media (OM)], deaths, and direct costs in each country of interest [stratified by PCV10/PCV13 countries, depending on national immunization programs (NIPs)] over 1 year, using up to the three most recent years of available serotype coverage data. Data inputs were sourced from local databases, surveillance reports, and published literature. RESULTS In 5 PCV10 NIPs (Austria, Finland, Netherlands, New Zealand, Sweden), most remaining PCV20-type disease was due to PCV13-unique serotypes (30-85%), followed by PCV20-unique (9-50%), PCV15-unique (4-15%), and PCV10-unique (2-14%) serotypes. In 8 PCV13 NIPs (Australia, Canada, France, Germany, Italy, South Korea, Spain, United Kingdom), most remaining PCV20-type disease was caused by PCV20-unique serotypes (16-69%), followed by PCV13-unique (11-54%), PCV15-unique (2-33%), and PCV10-unique serotypes (3-19%). Across all countries, PCV20 serotypes caused 3000 to 345,000 cases of disease and cost between $1.3 and $44.9 million USD annually with variability driven by population size, NIP status, and epidemiologic inputs. In aggregate, PCV20 serotypes caused 1,234,000 cases and $213.5 million in annual direct medical costs in children under 5 years of age. CONCLUSION Despite the success of PCV10 and PCV13 in reducing pneumococcal disease, a substantial clinical and economic burden remains due to serotypes contained in investigational vaccines.
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Affiliation(s)
- Matt D Wasserman
- Pfizer Inc., Health Economics and Outcomes Research, New York, USA. .,Patient and Health Impact, Global Health Economics and Outcomes Research, Pfizer Inc., 235 42nd Street, New York, NY, 10017, USA.
| | - Johnna Perdrizet
- Pfizer Inc., Health Economics and Outcomes Research, New York, USA
| | - Lindsay Grant
- Pfizer Inc., Medical and Scientific Affairs, New York, USA
| | - Kyla Hayford
- Pfizer Inc., Medical and Scientific Affairs, New York, USA
| | | | | | - Emily K Horn
- Pfizer Inc., Health Economics and Outcomes Research, New York, USA
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Perdrizet J, Horn EK, Nua W, Perez-Peralta J, Nailes J, Santos J, Ong-Lim A. Cost-Effectiveness of the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Versus Lower-Valent Alternatives in Filipino Infants. Infect Dis Ther 2021; 10:2625-2642. [PMID: 34591259 PMCID: PMC8482363 DOI: 10.1007/s40121-021-00538-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction The Philippines pediatric national immunization program (NIP) included the 13-valent pneumococcal conjugate vaccine manufactured by Pfizer (PCV13-PFE) since 2015. Uptake has been slow in particular regions, with coverage only reaching all regions in 2019. Given affordability challenges in the context of higher coverage, this study seeks to determine whether universal coverage across all regions of the Philippines with PCV13-PFE will provide good value for money compared with 10-valent PCV alternatives manufactured by GlaxoSmithKline (PCV10-GSK) or Serum Institute of India (PCV10-SII). Methods A decision analytic model is adapted for this cost-effectiveness analysis in the Philippines. Clinical and economic input parameters are taken from published sources. Future disease is predicted using age-stratified and population-level observed serotype dynamics. Total cases of pneumococcal disease, deaths, direct and indirect healthcare costs, and quality-adjusted life years (QALYs) gained are discounted 7% annually and modeled for each PCV. Given clinical uncertainty, PCV10-SII outcomes are reported as ranges. Incremental cost-effectiveness ratios (ICERs) are calculated for PCV13-PFE versus lower-valent PCVs (PCV10-GSK or PCV10-SII) from a societal perspective over 10 years. Results Nationwide PCV13-PFE use over 10 years is estimated to avert 375,831 more cases, save 53,189 additional lives, and gain 153,349 QALYs compared with PCV10-GSK. This equates to cost-savings of PHP 12.27 billion after vaccine costs are accounted for. Similarly, PCV13-PFE is more effective and cost-saving compared with PCV10-SII. Switching programs to PCV10-SII would result in more cases of disease (313,797 – 666,889), more deaths (22,759 – 72,435), and lost QALYs (108,061 – 266,108), equating to a net economic loss (PHP 359.82 million – 14.41 billion). PCV13-PFE remains cost-effective in the presence of parameter uncertainty. Conclusion PCV13-PFE would prevent exceedingly more cases and deaths compared with lower-valent PCVs. Additionally, the PCV13-PFE program is estimated to continue providing cost-savings, offering the best value for money to achieve universal PCV coverage in the Philippines.
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Affiliation(s)
- Johnna Perdrizet
- Global Health Economics and Outcomes Research, Pfizer Inc., 235 42nd Street, New York, NY, 10017, USA.
| | - Emily K Horn
- Global Health Economics and Outcomes Research, Pfizer Inc., 235 42nd Street, New York, NY, 10017, USA
| | | | | | - Jennifer Nailes
- Research Institute for the Health Sciences, University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jaime Santos
- Infectious Diseases Section, Philippine Children's Medical Center, Quezon City, Philippines
| | - Anna Ong-Lim
- Infectious and Tropical Disease, Department of Pediatrics, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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Wilson MR, McDade CL, Perdrizet JE, Mignon A, Farkouh RA, Wasserman MD. Validation of a Novel Forecasting Method for Estimating the Impact of Switching Pneumococcal Conjugate Programs: Evidence from Belgium. Infect Dis Ther 2021; 10:1765-1778. [PMID: 34250576 PMCID: PMC8322259 DOI: 10.1007/s40121-021-00485-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/15/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Since 2010, 10-valent (PCV10) and 13-valent pneumococcal conjugate vaccines (PCV13) have been available as part of infant national immunization programs. Belgium is as one of the few countries that implemented PCV13 (2007–2015), switched to PCV10 (2015–2018) and then switched back to PCV13 (2018–present) after observing increases in disease. We assessed the impacts of both historical and prospective PCV choice in the context of the Belgian health care system and used this experience to validate previously developed economic models. Methods Using historical incidence (2007–2018) of pneumococcal disease for Belgian children aged < 16 years, observed invasive pneumococcal disease (IPD) trends from surveillance data were used to estimate future disease in a given PCV13- or PCV10-based program. We compared observed incidence data with two modeled scenarios: (1) the 2015 switch to PCV10 and (2) a hypothetical continuation of PCV13 in 2015. Finally, we explored the potential impact of PCV choice from 2019 to 2023 by comparing three scenarios: (3) continued use of PCV10; (4) a switch back to PCV13; (5) a hypothetical scenario in which Belgium never switched from PCV13. Results Model predictions underestimated observed data from 2015 to 2018 by 100 IPD cases among ages < 16 years. Comparing observed data with scenario 2 suggests that PCV13 would have prevented 105 IPD cases from 2015 to 2018 compared with PCV10. Switching to PCV13 in 2019 would avert 625 IPD cases through 2023 compared with continuing PCV10. Scenario never switching from PCV13 would have resulted in a reduction of 204 cases from 2016 to 2023 compared with switching to PCV10 and switching back to PCV13. Conclusion The findings from this study suggest that previously published modeling results of PCV13 versus PCV10 in other countries may have underestimated the benefit of PCV13. These results highlight the importance of continually protecting against vaccine-preventable pneumococcal serotypes. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00485-9.
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Affiliation(s)
- Michele R Wilson
- RTI Health Solutions, 3040 Cornwallis Drive, PO Box 12194, Research Triangle Park, NC, 27709, USA.
| | - Cheryl L McDade
- RTI Health Solutions, 3040 Cornwallis Drive, PO Box 12194, Research Triangle Park, NC, 27709, USA
| | | | - Annick Mignon
- Pfizer SA/NV, 17 Boulevard de la Plaine, 1050, Brusssels, Belgium
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Calmeiro J, Carrascal MA, Tavares AR, Ferreira DA, Gomes C, Cruz MT, Falcão A, Neves BM. Pharmacological combination of nivolumab with dendritic cell vaccines in cancer immunotherapy: An overview. Pharmacol Res 2020; 164:105309. [PMID: 33212291 DOI: 10.1016/j.phrs.2020.105309] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/24/2020] [Accepted: 10/25/2020] [Indexed: 02/06/2023]
Abstract
In the last decade, immunotherapy led to a paradigm shift in the treatment of numerous malignancies. Alongside with monoclonal antibodies blocking programmed cell death receptor-1 (PD-1)/PD-L1 and cytotoxic T- lymphocyte antigen 4 (CTLA-4) immune checkpoints, cell-based approaches such as CAR-T cells and dendritic cell (DC) vaccines have strongly contributed to pushing forward this thrilling field. While initial strategies were mainly focused on monotherapeutic regimens, it is now consensual that the combination of immunotherapies tackling multiple cancer hallmarks can result in superior clinical outcomes. Here, we review in depth the pharmacological combination of DC-based vaccines that boost tumour elimination by eliciting and expanding effector immune cells, with the PD-1 inhibitor Nivolumab that allows blocking key tumour immune escape mechanisms. This combination represents an important step in cancer therapy, with a significant enhancement in patient survival in several types of tumours, paving an important way in establishing combinatorial immunotherapeutic strategies as first-line treatments.
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Affiliation(s)
- João Calmeiro
- Faculty of Pharmacy, FFUC, University of Coimbra, 3000-548, Coimbra, Portugal; Center for Neuroscience and Cell Biology, CNC, University of Coimbra, 3004-504, Coimbra, Portugal
| | - Mylène A Carrascal
- Center for Neuroscience and Cell Biology, CNC, University of Coimbra, 3004-504, Coimbra, Portugal; Tecnimede Group, 2710-089, Sintra, Portugal
| | - Adriana Ramos Tavares
- Faculty of Pharmacy, FFUC, University of Coimbra, 3000-548, Coimbra, Portugal; Center for Neuroscience and Cell Biology, CNC, University of Coimbra, 3004-504, Coimbra, Portugal
| | - Daniel Alexandre Ferreira
- Coimbra Institute for Clinical and Biomedical Research, iCBR, Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - Célia Gomes
- Coimbra Institute for Clinical and Biomedical Research, iCBR, Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal; Center for Innovation in Biomedicine and Biotechnology, CIBB, University of Coimbra, 300-504, Coimbra, Portugal
| | - Maria Teresa Cruz
- Faculty of Pharmacy, FFUC, University of Coimbra, 3000-548, Coimbra, Portugal; Center for Neuroscience and Cell Biology, CNC, University of Coimbra, 3004-504, Coimbra, Portugal
| | - Amílcar Falcão
- Faculty of Pharmacy, FFUC, University of Coimbra, 3000-548, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research, CIBIT, University of Coimbra, 3000-548, Coimbra, Portugal.
| | - Bruno Miguel Neves
- Department of Medical Sciences and Institute of Biomedicine, iBiMED, University of Aveiro, 3810-193, Aveiro, Portugal.
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