Objectives: To assess the effects of the National Centralized Drug Purchasing Pilot Program on nucleos(t)ide analogs (NAs) in Shenzhen city.Methods: Drugs procurement records in medical institutions were analyzed covering the period from January 2018 to December 2019. An interrupted time series (ITS) analysis was used to evaluate the impact of the “4+7” pilot policy on NAs in Shenzhen city. The outcome measures were usage volume, expenditures, daily cost, and distribution structure of NAs.Findings: After the introduction of the “4+7” pilot policy, the defined daily doses (DDDs) of NA drugs increased by 76.48%, the expenditures and defined daily dose cost (DDDc) of NAs decreased by 45.43 and 69.08%, respectively. The proportion of winning products in Entecavir and Tenofovir Fumarate DDDs was increased by 64.21 and 19.20%, respectively. The post-intervention period witnessed a significant increase in the regression level for NAs DDDs (level coefficient: β2 = 631.87, p < 0.05). The expenditures (trend coefficient: β3 = 392.24, p < 0.05) and DDDc (level coefficient: β2 = −6.17, p < 0.001; trend coefficient: β3 = −0.21, p < 0.05) of NAs showed decreasing trend in the post-intervention period. The expenditures of original products and generic products both showed a decreasing trend in the post-intervention period (trend coefficient: β3 = −372.78, p < 0.05, trend coefficient: β3 = −130.78, p < 0.05, respectively). The DDDc of original products in the policy-related varieties was a significant decrease in the regression slope and level (level coefficient: β2 = −2.18, p < 0.05; trend coefficient: β3 = −0.32, p < 0.01).Conclusion: After the implementation of the“4+7” policy, the DDDc of NAs decreased, the accessibility of policy-related drugs was improved, and the usage of generic medicine was promoted.

Objective: To evaluate the efficacy of lymphadenectomy for early-stage primary mucinous ovarian cancer (MOC). Design: Retrospective observation study Setting: Surveillance, Epidemiology, and End Results (SEER) database for 2000-2018 Population or sample: The study population comprised 1848 patients with early-stage MOC Methods: MOCs were divided into two groups according to lymphadenectomy. Propensity score matching were performed to correct for deviations. Independent risk factors for overall survival (OS) were determined by multivariate analysis using Cox regression. The role of lymphadenectomy was performed in different populations by stratified analysis applying interaction analysis. OS was calculated by Kaplan-Meier curves and compared by log-rank test. Main outcome measures: Overall survival Results: In the study, almost 65.8% (n = 1214/1848) experienced lymphadenectomy. Lymphadenectomy (HR = 0.692, 95% CI = 0.516-0.927, P = 0.009), age at diagnosis (HR = 3.028, 95% CI = 1.477-6.208, P = 0.002), and laterality (HR = 2.013, 95% CI = 1.145-3.54, P = 0.015) were found to be associated with OS. The role of lymphadenectomy varied by age group and tumor laterality, and the 5-year survival rates of patients with bilateral tumors who had experienced lymphadenectomy with sampling and dissection, or for MOC over age 50 and were higher than that of patients who did not undergo lymphadenectomy. Conclusion: Lymphadenectomy with sampling and dissection has little impact on OS in patients with early MOC. Lymph node therapy can be discontinued in patients younger than 50 years, and lymph node sampling is recommended for patients older than 50 years or with bilateral tumors.

5598 Background: Although the combination of immunotherapy and antiangiogenic agents has been proved a promising strategy in endometrial cancer, studies in Chinese patients are limited. In the earlier phase II study (NCT04157491), Chinese patients with recurrent or advanced endometrial cancer treated with sintilimab + anlotinib had an objective response rate of 73.9% (95% confidence interval [CI]: 51.6% to 89.8%). Here we further updated overall survival (OS) and subsequent therapy for this study. Methods: Patients with endometrial carcinoma progressed after platinum-based chemotherapy were enrolled. Sintilimab 200 mg was supplied intravenously on day one, whereas anlotinib 12 mg was administered orally on day 1 - 14 every three weeks. Results: Twenty-three patients were enrolled in the study. 47.8% of patients received ≥ 2 lines of prior chemotherapy; microsatellite instability-high/mismatch repair deficiency (MSI-H/dMMR) and microsatellite instability stable/mismatch repair proficient (MSS/pMMR) accounted for 39.1% and 60.9% of patients, respectively. We observed a median OS of 17.8 months (95% CI, 9.4 to 26.3 months). Patients with microsatellite instability-high (MSI-H) had superior OS than their counterparts (not available vs. 13.3 months; HR 0.15, 95% CI, 0.33-0.70; P = 0.006). All patients had dropped out of the cohort [56.5% progression disease (PD), 13.0% adverse events (AE)]. Notably, five patients with partial responses (PRs) obtained pathological or radiography complete responses (CRs) in the follow-up. Pathological CRs were confirmed in three patients with long-lasting PRs who underwent surgery, consistent with PET/CT scans. Two patients with PR continued to have tumor shrinkage following treatment cessation due to AE and achieved CR during follow-up. Three out of four patients with CR experienced recurrences. There were no new grade 3-4 AEs associated with therapy. Conclusions: In terms of OS, combining sintilimab and anlotinib had promising therapeutic effects. Pathological CR was observed in patients with long-lasting PR, thus exploratory surgery may be required in selected patients. Clinical trial information: NCT04157491 . [Table: see text]