Sequential Targeted Therapy for Advanced, Metastatic, and Recurrent Cervical Cancer: A Cost-Effectiveness Analysis of the Patient Journey

Abstract

Objectives To evaluate outcomes and cost-effectiveness of targeted therapy sequencing for metastatic and recurrent cervical cancer. Method Models were simulated based on phase II and III trials on bevacizumab (bev) from GOG-240, cemiplimab (cemi) from GOG 3016, pembrolizumab (pembro) from KEYNOTE-826, and tisotumab vedotin (tiso) from GOG 3023. Costs were based on IBM Micromedex RED BOOK™ and company listed costs. Results For [chemo + bev → chemo], total cost was $125,918.04, with median overall survival (mOS) of 21.8 months, and cost-effectiveness ratio (CER) of $119,835.79. For [chemo + bev → cemi], total cost was $187,562.99 with mOS of 28.5 months and CER of $162,039.16. For [chemo + bev + pembro → chemo], total cost was $319,963.78 with mOS 32.9 months and CER of $249,930.10. For [chemo + bev + pembro → tiso], total cost was $455,204.45, with mOS 36.5 months and CER of $320,072.99. Conclusion The combination of immunotherapies and biologics have significantly increased overall survival, but with associated higher costs, primarily related to drug costs.

Knowledge mapping of immunotherapy in cervical carcinoma: a bibliometric analysis (2000-2023)

“…Tewari, Krishnansu S (167 co-citations) ranked first, followed by Santin, Alessandro D (137 co-citations) and Monk, Bradley J (131 co-citations). Tewari, Krishnansu S have achieved significant results in targeted therapy ( 23 ), chemotherapy ( 24 , 25 ), clinical prognosis ( 26 ) and survival research ( 27 ) for cervical cancer. His contributions have propelled the field forward and provided valuable insights into potential treatment approaches.…”