ArticleAdvances in therapy2023
Cost-Effectiveness of Neoadjuvant Pembrolizumab Plus Chemotherapy Followed by Adjuvant Single-Agent Pembrolizumab for High-Risk Early-Stage Triple-Negative Breast Cancer in the United States.
Article in Advances in therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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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.
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.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Defining and modeling 'cure' in early-stage melanoma: perspectives from a systematic literature review.Frontiers in oncology · 2026Pooled it
- Under-reporting of Validation Efforts for Health Economic Models Persists Despite the Availability of Validation Tools: A Systematic Review.PharmacoEconomics · 2025Pooled it
- Recurrence detection in patients with triple-negative breast cancer following the current standard of care: a microsimulation model.BMJ open · 2026Article
- Assessing the Impact on Health and Productivity Outcomes of Anti-PD-(L)1 Agents to Treat Early-Stage Cancers in Italy.Clinical drug investigation · 2026Article
- Botulinum Neurotoxin-A Inhibits Tumor Growth in a Triple-Negative Breast Cancer Preclinical Model.Toxins · 2026Article
- Antibody-Drug Conjugates Reshape the Landscape of Cancer Therapy: Evolution, Challenges and Future Perspectives from the Concept of "Magic Bullet" to Clinical Application.Current oncology reports · 2026Review
- The broad societal value of pembrolizumab for women's cancer in Canada.Future oncology (London, England) · 2026Article
- A comparative review of economic evaluations for immune checkpoint inhibitors in early stage and advanced stage cancer: focusing on pembrolizumab.Frontiers in pharmacology · 2026Review
- Triple-Negative Breast Cancer Unveiled: Bridging Science, Treatment Strategy, and Economic Aspects.International journal of molecular sciences · 2025Review
- Clinical and economic impact of recurrence in unresected non-small cell lung cancer treated with primary stereotactic body radiotherapy: A real-world study using SEER-Medicare data.Journal of managed care & specialty pharmacy · 2025Article
- The Health Impact of Using Anti-PD-1 Agents to Treat Early-Stage Cancer in Belgium.Oncology and therapy · 2025Article
- Budget impact analysis of neoadjuvant nivolumab for non-small cell lung cancer in the Chilean public healthcare system: An exploratory economic assessment.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Improving assessment of financial toxicity of cancer immunotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Cost-Effectiveness of Pembrolizumab With Chemoradiotherapy for Locally Advanced Cervical Cancer.JAMA network open · 2025Article
- Cost-effectiveness analysis of toripalimab combined with nab-paclitaxel as a first-line treatment for advanced TNBC in the US.PloS one · 2025Article
- Health impact of using anti-PD-(L)1 agents to treat early-stage cancers in Switzerland: a modeling study.Frontiers in immunology · 2025Article
- Cost-effectiveness analysis of pembrolizumab plus chemotherapy versus placebo plus chemotherapy for patients with previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer in China.Frontiers in pharmacology · 2025Article
- Review
- A Narrative Review of the Clinical, Humanistic, and Economic Value of Pembrolizumab-Based Immunotherapy for the Treatment of Breast and Gynecologic Cancers.Oncology and therapy · 2024Review
- Cost-effectiveness of Pembrolizumab in Combination with Chemotherapy as Neoadjuvant Treatment and Continued as a Single Agent Adjuvant Treatment for High-Risk Early-Stage Triple-Negative Breast Cancer in Hong Kong.Oncology and therapy · 2024Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe randomized phase III KEYNOTE-522 trial demonstrated that addition of pembrolizumab to neoadjuvant chemotherapy provided a significant improvement in event-free survival and a favorable trend in overall survival for high-risk early-stage triple-negative breast cancer (eTNBC). This analysis evaluated the cost-effectiveness of pembrolizumab in combination with chemotherapy as neoadjuvant treatment and continued as a single-agent adjuvant treatment after surgery vs. neoadjuvant chemotherapy for patients with high-risk eTNBC in the USA.
methodsThe analysis was conducted from a US third-party public healthcare payer perspective. A multistate transition model was developed using efficacy and safety data from the KEYNOTE-522 trial. The model included four mutually exclusive health states: event-free, locoregional recurrence, distant metastasis, and death to simulate patients' lifetime disease course. Quality-adjusted life years (QALYs) were calculated on the basis of EuroQoL-5 Dimensions utility data collected in KEYNOTE-522. Costs for drug acquisition/administration, adverse events, disease management, and subsequent therapies were reported (2021 US dollars). Costs and outcomes were discounted at 3% annually. A series of sensitivity analyses were performed to test the robustness of the main results.
resultsIn the base case scenario, pembrolizumab plus chemotherapy followed by pembrolizumab resulted in expected gains of 3.37 life years (LYs) and 2.90 QALYs, and an incremental cost of $79,046 versus chemotherapy. The incremental cost per QALY gained was $27,285, which is lower than all commonly cited US willingness-to-pay thresholds. Sensitivity analyses showed the results were robust over plausible values of key model inputs and assumptions.
conclusionsCompared with neoadjuvant chemotherapy, pembrolizumab in combination with chemotherapy as neoadjuvant treatment and continued as a single-agent adjuvant treatment after surgery is considered a cost-effective option for high-risk eTNBC in the USA.
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