2/18/2024 0 Comments Keynote 590 resultsIn recent years, immunotherapy and immune checkpoint inhibitors (ICIs) have provided new therapeutic options and shown good performance in ESCC ( 9, 10). Therefore, the treatment of ESCC has gradually become a more and more difficult problem and new treatment strategies are urgently needed. However, the overall 5 years survival rate of ESCC was poor and reported as 20.9% in China ( 8). For patients with advanced or metastatic ESCC, a combination of 5-fluoropyrimidine and platinum-based chemotherapy was recommended as first-line therapy ( 6, 7). Despite advances in the multidisciplinary treatment of ESCC, treatment options for unresectable, locally advanced, or metastatic esophageal cancer are still limited ( 5). Esophageal squamous cell carcinoma (ESCC) is the major histological type of esophageal cancer, which accounts for about 90% of the 456,000 incident esophageal cancers each year ( 4). In China, EC is the fourth most common cause of mortality, with 30.1 deaths per 100,000 in 2020 ( 2, 3). The crude mortality rate of EC was 7.8/100,000 in 2020, which represented 5.5% of all cancer deaths and ranked as the sixth most common cause of cancer death ( 1). The sensitivity analysis demonstrated that the ICERs were most sensitive to the cycle of pembrolizumab used and the cost of pembrolizumab.Ĭonclusion: The result of our present analysis suggests that the addition of pembrolizumab plus chemotherapy as first-line treatment might not be cost-effective for patients with ESCC and PD-L1 CPS of 10 or more in China.Įsophageal cancer (EC) is one of the most common malignant tumors in the world. chemotherapy alone added 1.23 QALYs and resulted in an incremental cost of $51,320.22, which had an ICER of $41,805.12/QALY, higher than the willingness-to-pay (WTP) threshold of China ($37,663.26/QALY). Results: The baseline analysis indicated that the incremental effectiveness and cost of pembrolizumab plus chemotherapy vs. One-way and probabilistic sensitivity analyses were conducted to check the stability of the model. Utility values and direct costs related to the treatments were gathered from the published literature data. chemotherapy alone in first-line treatment of ESCC and PD-L1 CPS of 10 or more. Methods: Based on the advanced ESCC of the KEYNOTE-590 clinical trial data, a Markov model was performed to simulate the clinical course and evaluate the patient's total lifetime, total costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) for pembrolizumab plus chemotherapy (cisplatin and 5-fluorouracil) vs.
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