Value assessment of PD-1/PD-L1 inhibitors in the treatment of esophageal and gastrointestinal cancers
- Only a few treatment regimens showed clinical value in EC and CRC using ASCO-VF and ESMO-MCBS frameworks.
- Nivolumab met valuable threshold in resectable locally advanced EC/GEJC.
- 14 positive therapeutic regimens assessed; 11 negative regimens showed no improvement in QoL and were below the value threshold.
- Pembrolizumab showed clinical value in first-line therapy for microsatellite instability–high CRC.
- Camrelizumab and toripalimab showed clinical value in EC and have relatively low prices in China.
- The prices of PD-1/PD-L1 inhibitors are not aligned with their value; a negative correlation was found between prices and their value scores.
- 8 of 14 positive regimens did not meet the threshold value, suggesting a compromise in QoL or increased toxicity.
According to GLOBOCAN data, colon cancer, gastric cancer (GC), rectal cancer and esophageal cancer (EC) are among the top 10 cancers in terms of incidence, and digestive system cancers have become one of the most serious disease burdens. In recent years, the use of programmed cell death 1 (PD-1) and programmed death ligand-1 (PD-L1) inhibitors in the treatment of digestive system cancers has been proven to improve the survival of patients and has become an important research topicality. However, our previous study found that the efficacy and safety of PD-1/PD-L1 inhibitors in EC, GC and colorectal cancer (CRC) were inconsistent , which extremely confused their clinical application and usefulness in aiding decision-making....
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