He was treated with Sintilimab plus Anlotinib, resulting in lung lesion regression. Both tumors showed high proliferative indices (Ki-67 ~80-90%) and PD-L1 expression, supporting responsiveness to immune checkpoint blockade. This case highlights the feasibility of immune monotherapy in managing complex synchronous malignancies, especially when standard treatments are declined.
Adjuvant immunotherapies for lung cancer deliver meaningful clinical benefits, but their economic value and affordability are highly context-specific. While several strategies are cost-effective at the individual patient level, health system affordability is strongly influenced by the pace and scale of adoption. Scenario-based budget impact analyses demonstrate that accelerated uptake can impose substantial short-term fiscal pressure, whereas phased or restricted implementation markedly improves affordability without altering cost-effectiveness conclusions. These findings underscore the importance of integrating cost-effectiveness evidence with explicit consideration of budget impact, adoption strategies, and managed entry mechanisms to support sustainable and equitable scale-up of adjuvant immunotherapies in routine clinical practice.
P3, N=446, Active, not recruiting, Second Affiliated Hospital, School of Medicine, Zhejiang University | Trial primary completion date: Dec 2025 --> Dec 2026 | Recruiting --> Active, not recruiting