Evidence map›Paper›PMID 40619779›Full record

ArticleJournal of gynecologic oncology2025

International cost-effectiveness analysis of chemoradiotherapy plus pembrolizumab for locally advanced cervical cancer.

Kun Liu, Youwen Zhu, Hong Zhu

Abstract read
In one paragraph

Article in Journal of gynecologic oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Kun LiuDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.ORCID 0000-0001-6720-3310
Youwen ZhuDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.ORCID 0000-0001-8692-3591
Hong ZhuDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.ORCID 0000-0002-3659-8070

Funding

Changsha Natural Science Foundation of Hunan Provincial of China kq2208376
6 · The paper itself

Abstract

objectivePembrolizumab administration can improve concurrent chemoradiotherapy (CCRT) efficacy in newly diagnosed, high-risk, locally advanced cervical cancer (LACC). Given the importance of balancing the costs of innovative therapeutics against their efficacy, this study was developed to assess the cost-effectiveness from the perspective of payers in Americas, Europe, and Asia.

methodsThe main survival and other relevant parameters of 1,060 LACC patients from the KEYNOTE-A18 trial were collected to establish a lifetime 3-state Markov model to evaluate the cost and effectiveness of pembrolizumab-CCRT and placebo-CCRT. Primary outcome measures included total cost, life-years (LYs), quality-adjusted LYs (QALYs), incremental cost-effectiveness ratio (ICER), incremental net monetary benefit, and incremental net health benefits (INHBs) at countries' traditional willingness-to-pay (WTP) thresholds. Model stability was also examined through sensitivity analyses.

resultsThe USA, Italy, and China are selected as representative countries for each of the 3 continents, assuming that their WTP thresholds were $150,000, $43,749, and $37,766 per QALY. The increased efficacy and costs of pembrolizumab-CCRT versus placebo-CCRT were 2.52 QALYs (3.11 LYs) and $346,479, 2.30 QALYs (2.81 LYs) and $236,776, 1.79 QALYs (2.12 LYs) and $29,027, calculating the ICER for the 3 countries as $137,500/QALY ($111,499/LY), $102,758/QALY ($84,192/LY), and $16,217/QALY ($13,726/LY), respectively. The respective INHBs were 0.21 QALY, -3.11 QALY, and 1.02 QALY, and pembrolizumab-CCRT was exhibited cost-effectiveness opportunities of 62.68%, 12.53%, and 75.23% at the selected WTP threshold, respectively.

conclusionAt current prices, pembrolizumab-CCRT represents a cost-effective alternative for patients with LACC in the USA and China, but not in Italy.

Indexed as

Antibodies, Monoclonal, HumanizedChemoradiotherapyImmune Checkpoint InhibitorsUterine Cervical NeoplasmsChinaClinical Trials, Phase III as TopicCost-Effectiveness AnalysisFemaleHumansItalyMarkov ChainsMiddle AgedMulticenter Studies as TopicProgression-Free SurvivalQuality-Adjusted Life YearsRandomized Controlled Trials as TopicAntibodies, Monoclonal, HumanizedImmune Checkpoint InhibitorspembrolizumabChemoradiotherapyCost-Effectiveness AnalysisPembrolizumabQuality-Adjusted Life YearsUterine Cervical Neoplasms

Identifiers

PMID40619779
PMCPMC12636136

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Registered trials

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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.