Background: Cytotoxic chemotherapy can induce myelosuppression and have an influence on a cancer patient’s quality of life (QOL). Two newer products developed to prevent chemotherapy-induced myelosuppression, plinabulin and trilaciclib, have primarily been studied in early-stage breast and advanced lung cancer. This systematic literature review sought to characterize empirically derived health state utility values (HSUVs) of chemotherapy-induced myelosuppression at any stage of breast cancer (BC), small cell lung cancer (SCLC), and non-small cell lung cancer (NSCLC).

Methods: We searched EMBASE and MEDLINE to identify studies containing HSUVs for cancer patients with neutropenia, febrile neutropenia (FN), anemia, or thrombocytopenia. After initial study identification, a review of the reference sections of the systematic reviews and cost-effectiveness analyses was performed to ensure complete article capture. Data was abstracted on utility scores, cancer types, therapy lines, interventions, comparators, methods, and sources for HSUV valuation. We used descriptive statistics to characterize the quantitative estimates from the studies.

Results: Of 1,515 individual studies identified, 7 studies were included. Only studies on advanced cancers were found, with BC (n=3) and NSCLC (n=3) being equally represented, and one study for SCLC. Only FN (n=7) and neutropenia (n=3) were captured in these cancer types. The utility score for FN in BC ranged from 0.24 to 0.42, with FN disutility being cited as -0.15. For NSCLC, neutropenia and FN HSUVs were cited as 0.32 and 0.19, respectively. In SCLC, FN resulted in a utility of 0.57 without CSF and 0.36 while on CSF.

Conclusion: There is a substantial disutility for myelosuppressive events which varies somewhat by cancer type and clinical situation. These disutilities are on top of already low health related quality of life for patients with cancer undergoing chemotherapy. Properly assessing the value of avoiding myelosuppressive effects in patients early in cancers could have large implications for health resource allocation.