Evidence map›Paper›PMID 34103196›Full record

ArticleGynecologic oncology2021

Pembrolizumab and lenvatinib versus carboplatin and paclitaxel as first-line therapy for advanced or recurrent endometrial cancer: A Markov analysis.

Sarah A Ackroyd, Elbert S Huang, Katherine C Kurnit, Nita K Lee

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Gynecologic oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 34 citations in OpenAlex.

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  14. Endometrial Cancer Stem Cells: Where Do We Stand and Where Should We Go?International journal of molecular sciences · 2022
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Sarah A AckroydUniversity of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, 5841 S Maryland Ave, Chicago, IL 60637, USA. Electronic address: Sarah.Ackroyd@uchospitals.edu.
Elbert S HuangUniversity of Chicago Medicine, Department of Medicine, Section of General Internal Medicine, Center for Chronic Disease Research and Policy, 5841 S Maryland Ave, Chicago, IL 60637, USA.
Katherine C KurnitUniversity of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, 5841 S Maryland Ave, Chicago, IL 60637, USA.
Nita K LeeUniversity of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, 5841 S Maryland Ave, Chicago, IL 60637, USA.
University of Chicago · US

Funding

Research Design, Data, and Analytics CoreP30DK092949 · NIDDK · UNIVERSITY OF CHICAGO · PI Ronald T. Ackermann, MARSHALL H CHIN · 2011 to 2026
$10.0M
NIDDK NIH HHS P30 DK092949
6 · The paper itself

Abstract

objectiveTo determine the cost effectiveness of pembrolizumab/lenvatinib (P/L) versus standard-of-care carboplatin/paclitaxel (C/T) as first-line systemic therapy for patients with advanced/recurrent endometrial cancer.

methodsWe designed a Markov model to simulate treatment outcomes for advanced/recurrent endometrial cancer patients whose tumors are either microsatellite stable (MSS) or have high microsatellite instability (MSI-high). We adopted a healthcare sector perspective for the analysis. Model inputs for costs, health utility, and clinical estimates were obtained from the literature including data from GOG0209 and KEYNOTE-146. Primary outcomes included costs of care, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). The time-horizon was three years and the discount rate was 3% annually.

resultsIn a MSS cohort, compared to C/T, first-line treatment with P/L increased treatment costs by $212,670 and decreased QALYs by 0.28 per patient. In a MSI-high cohort, compared to C/T, P/L increased costs by $313,487 and increased QALYs by 0.11 per patient, representing an ICER of $2,849,882 per QALY. Sensitivity analyses found that the price of the new drugs was the most important determinant of the ICER and that the price of the new drugs would need to decrease by 85% to $2817 per cycle to reach a $150,000/QALY threshold.

conclusionIn the MSS model, we found that first-line therapy for advanced or recurrent endometrial cancer with P/L increased costs and worsened outcomes compared to C/T. In the MSI-high model, P/L improved survival and QALYs compared to C/T but was not cost-effective at the current cost of the drugs.

Indexed as

Drug CostsAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCarboplatinCost-Benefit AnalysisDecision TreesEndometrial NeoplasmsFemaleHumansMarkov ChainsMicrosatellite InstabilityNeoplasm Recurrence, LocalNeoplasm StagingPaclitaxelPhenylurea CompoundsProgression-Free SurvivalAntibodies, Monoclonal, HumanizedCarboplatinlenvatinibPaclitaxelpembrolizumabPhenylurea CompoundsQuinolinesAdvanced and recurrent endometrial cancerCost-effectivenessImmunotherapy

Identifiers

PMID34103196
PMCPMC8663341
OpenAlexW3165913143

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.