• Ahmad Tarhini, Agnes Benedict, David McDermott, Sumati Rao, Apoorva Ambavane, Komal Gupte-Singh, Javier Sabater, Corey Ritchings, Valerie Aponte-Ribero, Meredith M Regan, and Michael Atkins.
• Department of Hematology & Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, OH, USA.
• Immunotherapy. 2018 Oct 1; 10 (14): 1241-1252.

AimTo evaluate the cost-effectiveness of treatment sequences with checkpoint inhibitors in patients with BRAF wild-type melanoma.Materials & MethodsUsing a discrete event simulation model, cost and health outcomes were estimated. Pooled data from CheckMate 067/069 trials were used to calculate survival outcomes including treatment-free interval extrapolated over a patient's lifetime. Costs accounted for treatment, administration, toxicity, and disease management.ResultsFirst-line anti-PD-1 + anti-CTLA-4 initiating sequences had the highest estimated mean survival gain (7.6-7.7 years), driven by a longer estimated mean treatment-free interval (5.3 years). Incremental costs per incremental quality-adjusted life year gained for anti-PD-1 + anti-CTLA-4 followed by chemotherapy were US$30,955 versus anti-PD-1 initiating sequences, within the willingness-to-pay threshold.ConclusionAnti-PD-1 + anti-CTLA-4 initiating sequences for BRAF wild-type melanoma are cost-effective versus anti-PD-1.

41 keywords...

hide…