ArticleJournal of ovarian research2026
Immune checkpoint inhibitors-based therapies for first-line treatment of advanced ovarian cancer with non-BRCAm/HRD-negative: a cost-effectiveness analysis.
Article in Journal of ovarian research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEmerging evidence supports the clinical potential of immune checkpoint inhibitors (ICIs) with or without bevacizumab and poly-(adenosine diphosphate-ribose) polymerase (PARP) inhibitors for refractory advanced ovarian cancer (AOC) with BRCA non-mutated (non-BRCAm) and homologous recombination deficiency-negative (HRD-negative). However, broader adoption hinges on a thorough economic evaluation.
methodsA lifetime Markov model was developed to assess the cost-effectiveness of six first-line treatment strategies for AOC in non-BRCAm/HRD-negative patients: chemotherapy alone (C); bevacizumab plus chemotherapy (BC); durvalumab plus chemotherapy and bevacizumab with or without olaparib (DBC or DBCO); and pembrolizumab plus chemotherapy with or without olaparib (PC or PCO). Model inputs were informed by patient demographics and clinical outcomes reported in the DUO-O and KEYLYNK-001 trials, as well as aggregated cost data relevant to the American healthcare system. Primary outcomes included incremental cost-effectiveness ratios (ICERs) and incremental net health benefits (INHBs) at the willingness-to-pay (WTP) threshold of $150,000/quality-adjusted life year (QALY).
resultsCompared to C, the ICERs (with INHBs) for BC, DBC, DBCO, PC, and PCO were $2,632,524/QALY (-0.73 QALY), $2,005,771/QALY (-1.73 QALY), $7,351,200/QALY (-2.88 QALY), $484,706/QALY (-1.46 QALY), and $1,382,130/QALY (-2.46 QALY), respectively. The comparison among ICI-based treatment regimens revealed that PC had high efficacy and low cost compared with DBCO and PCO, and the ICER of PC versus DBC was $69,253/QALY.
conclusionsNone of the ICI-based or BC proved cost-effective versus C for newly diagnosed AOC with non-BRCAm/HRD-negative. However, PC offers a cost-effective alternative when compared with other ICI-based strategies.
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