AUTHOR=Ren Lanqi , Ren Ning , Zheng Yu , Yang Yibei , Xu Qiaoping TITLE=Economic evaluation of third-line neratinib plus capecitabine versus lapatinib plus capecitabine with HER2+ metastatic breast cancer JOURNAL=Frontiers in Oncology VOLUME=Volume 13 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1221969 DOI=10.3389/fonc.2023.1221969 ISSN=2234-943X ABSTRACT=Background:Breast cancer (BC) is one of the most common malignant tumors in women. And human epidermal growth factor receptor 2-positive (HER2+) BC is overexpressed in 25% of BC patients, resulting in the predicament of poor prognosis. Though first-line and second-line treatment has been established, optimum third-line treatment is still mired in controversies for HER2+ metastatic BC (mBC). Therefore, this study analyzes the cost-effectiveness of neratinib plus capecitabine (N+C) and lapatinib plus capecitabine (L+C) over a 5-year time horizon from a payer perspective.Methods:A half-cycle corrected four-state Markov model was established to simulate the course of BC events and deaths in N+C and L+C armed patients. The data of this model were derived from NCT01808573 trail and other published literatures. One-way deterministic sensitivity analysis (DSA) was conducted to investigate the impact of variables and probabilistic sensitivity analysis (PSA) was performed based on second-order Monte Carlo simulation. Besides, subgroup analysis was performed to verify its cost-effectiveness in China.The base-case results found that N+C was in dominant position in 82.70% of the generation scenarios, providing an improvement of 0.