{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T19:25:04Z","timestamp":1786908304895,"version":"build-2736575974"},"reference-count":24,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Healthcare Consulting, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Platinum\u2013etoposide combined with a PD-L1 inhibitor (atezolizumab or durvalumab) is the standard first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). Although phase 3 trials have demonstrated similar efficacy, no direct comparison exists, and differences in treatment cost and resource utilization may influence clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter retrospective study, real-world data from eight Japanese institutions were analyzed. Patients with ES-SCLC treated with platinum\u2013etoposide plus atezolizumab or durvalumab between August 2018 and December 2022 were included. Individual-level medical costs were calculated from health insurance claims linked to electronic medical records. After propensity score matching and exclusion of cisplatin-treated patients, 128 patients were analyzed. The primary outcome was mean monthly medical cost during immunotherapy. Secondary outcomes included overall survival (OS), immune-related adverse events (irAEs), and prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 128 patients (mean age, 74\u00a0years; 85% male), mean monthly medical cost was significantly lower with atezolizumab than durvalumab (\u00a51\u2009003\u2009922 [$7183] vs \u00a51\u2009596\u2009511 [$11\u2009422]; P\u00a0&amp;lt;\u00a0.001). Median OS was comparable (13.9\u00a0months [95% CI, 11.7\u201317.5] vs 14.8\u00a0months [95% CI, 10.5\u2013not reached]; P\u00a0=\u00a0.92). Grade\u00a0\u22652 irAEs (11% vs 31%; P\u00a0=\u00a0.009) and interstitial lung disease (3% vs 20%; P\u00a0=\u00a0.004) were less frequent with atezolizumab. Poor performance status was associated with worse OS, whereas treatment type was not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Atezolizumab was associated with lower medical costs and similar survival outcomes compared with durvalumab in ES-SCLC, suggesting its use as a clinically comparable option with lower associated costs in Japanese real-world practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag128","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:42:46Z","timestamp":1785159766000},"source":"Crossref","is-referenced-by-count":0,"title":["Atezolizumab vs durvalumab for extensive-stage small cell lung cancer in Japan: a real-world comparative analysis of costs and clinical outcomes"],"prefix":"10.1093","author":[{"given":"Katsuya","family":"Hirano","sequence":"first","affiliation":[{"name":"Division 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,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-5878","authenticated-orcid":false,"given":"Toshiyuki","family":"Sumi","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Hakodate Goryoukaku Hospital , 38-3, Goryokaku-cho, Hakodate, Hokkaido, 040-8611 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohiro","family":"Tamiya","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology, Osaka International Cancer Institute , 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kobe City Medical Center General Hospital , 2-1-1, Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Oya","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Fujita Health University , 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Hamai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JA Onomichi General Hospital , 1-10-23 Hirabara, Onomichi, Hiroshima, 722-8508 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1851-5788","authenticated-orcid":false,"given":"Nobuyuki","family":"Katakami","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Takarazuka City Hospital , 4-5-1, Kohama, Takarazuka, Hyogo 665-0827 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