1/11/2024 0 Comments Keynote 590 results![]() Due to the overall 5-year survival rate for people with ESCC, being ~20% or less ( 8), the time horizon of the model was set to 10 years. The model included three mutually exclusive health states: progression-free disease (PFD), progressive disease (PD), and death ( Figure 1). chemotherapy alone as first-line therapy for patients with advanced or metastatic ESCC and PD-L1 CPS of 10 or more in China. Hence, the purpose of our study was to analyze the economics of pembrolizumab plus chemotherapy for first-line treatment in patients with ESCC and PD-L1 CPS of 10 or more based on the KEYNOTE-590 trial from the perspective of the Chinese healthcare system.Ī Markov model was established to analyze the clinical and economic outcomes of pembrolizumab plus chemotherapy vs. However, the high cost of pembrolizumab could have far-reaching economic consequences. The outstanding performance with significant improvements in PFS and OS showed the apparent benefit of pembrolizumab treatment as first-line with advanced ESCC. 5.5 months) and median overall survival (OS median 13.9 vs. The result showed that pembrolizumab plus chemotherapy significantly prolonged median progression-free survival (PFS median 7.5 vs. chemotherapy alone for first-line treatment of advanced ESCC. The KEYNOTE-590 trial was conducted to evaluate the efficacy of pembrolizumab plus chemotherapy vs. 6.7 months with chemotherapy as second-line therapy in patients with ESCC and PD-L1 CPS of 10 or more ( 12).īased on phase III clinical trial KEYNOTE-590, the National Medical Products Administration of China approved pembrolizumab for treating patients with advanced or metastatic ESCC whose tumors express PD-L1 CPS of 10 or more ( 13). Another phase III KEYNOTE-181 study showed that pembrolizumab provided a median overall survival of 10.3 vs. Among them, pembrolizumab used alone provided an overall response rate of 14% in ESCC and PD-L1 combined positive score (CPS) of 10 or more as third-line therapy in phase 2 KEYNOTE-180 study ( 11). In recent years, immunotherapy and immune checkpoint inhibitors (ICIs) have provided new therapeutic options and shown good performance in ESCC ( 9, 10). Therefore, the treatment of ESCC has gradually become a more and more difficult problem and new treatment strategies are urgently needed. However, the overall 5 years survival rate of ESCC was poor and reported as 20.9% in China ( 8). For patients with advanced or metastatic ESCC, a combination of 5-fluoropyrimidine and platinum-based chemotherapy was recommended as first-line therapy ( 6, 7). Despite advances in the multidisciplinary treatment of ESCC, treatment options for unresectable, locally advanced, or metastatic esophageal cancer are still limited ( 5). Esophageal squamous cell carcinoma (ESCC) is the major histological type of esophageal cancer, which accounts for about 90% of the 456,000 incident esophageal cancers each year ( 4). In China, EC is the fourth most common cause of mortality, with 30.1 deaths per 100,000 in 2020 ( 2, 3). The crude mortality rate of EC was 7.8/100,000 in 2020, which represented 5.5% of all cancer deaths and ranked as the sixth most common cause of cancer death ( 1). Esophageal cancer (EC) is one of the most common malignant tumors in the world.
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