分子靶向药物和免疫检查点抑制剂已被开发用于治疗各种恶性疾病，从而改善临床结果。然而，这些药物价格昂贵，很少有研究评估它们在日本的实际使用和成本。本研究旨在调查现实世界中晚期/复发性胃癌 (AGC) 一线化疗的使用情况和费用。该调查包括人类表皮生长因子受体 2 型 (HER2) 阴性 AGC 患者，他们开始了一线化疗2022 年 1 月至 2022 年 12 月在日本临床肿瘤学组的 92 家参与机构进行一线化疗。使用谷歌表格收集有关治疗方案的数据。每月花费> 500 000日元（JPY）的方案被定义为昂贵。化疗方案的数据收集自2023年3月至2023年5月期间所有92个机构的2173名患者。我们分析了2113名接受推荐方案化疗的患者并根据日本胃癌治疗指南第六版有条件推荐治疗方案。昂贵的方案是氟嘧啶（S-1 或卡培他滨或 5-氟尿嘧啶/左亚叶酸）、奥沙利铂和纳武单抗的三联化疗。他们每月的费用从 767 648 日元到 771 046 日元不等。含纳武单抗的治疗方案的成本是氟嘧啶和奥沙利铂常规化疗的 20 倍以上。这些方案在 2113 名患者中的 1416 名 (67%) 中使用：71% 的患者年龄≤74 岁，59% 的患者年龄 ≥75 岁。成本为常规化疗 20 倍以上的方案被用作第一方案三分之二的患者接受了一线化疗，甚至在 HER2 阴性 AGC 的老年人群中也有超过一半的患者接受了一线化疗。这一发现对于未来药物成本效益的健康经济学研究非常重要。© 作者 2024。由牛津大学出版社出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Molecular-targeted drugs and immune checkpoint inhibitors have been developed for various malignant diseases, thereby improving clinical outcomes. However, these drugs are expensive, and few studies have assessed their actual use and costs in Japan. This study aimed to survey the use and costs of first-line chemotherapy for advanced/recurrent gastric cancer (AGC) in real-world settings.The survey included patients with human epidermal growth factor receptor type2 (HER2)-negative AGC who initiated first-line chemotherapy from January 2022 to December 2022 at the participating 92 institutions in the Japan Clinical Oncology Group. Data on the regimens were collected using Google Forms. A regimen that costs >500 000 Japanese yen (JPY) per month was defined as expensive.Data on chemotherapy regimens were collected from 2173 patients at all 92 institutions between March 2023 and May 2023. We analyzed 2113 patients who underwent the chemotherapy with recommended regimens and conditionally recommended regimens according to the Japanese Gastric Cancer Treatment Guidelines sixth edition. The expensive regimens were triplet chemotherapy with fluoropyrimidine (S-1 or capecitabine or 5-fluorouracil/levofolinate), oxaliplatin, and nivolumab. Their monthly costs ranged from 767 648 to 771 046 JPY. Nivolumab-containing regimens cost more than 20 times the price of conventional chemotherapy with fluoropyrimidine and oxaliplatin. These regimens were used in 1416 (67%) of 2113 patients: in 71% of patients aged ≤74 years and in 59% of patients aged ≥75 years.The regimens with >20-fold cost of conventional chemotherapy were used as first-line chemotherapy in two-thirds of patients and more than half even in the elderly population with HER2-negative AGC. This finding is important for future health economic studies on drug cost-efficacy.© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.