1/19/2024 0 Comments Keynote 590 results![]() All individuals received pembrolizumab plus chemotherapy or chemotherapy in the PFS state, and as the model was run, individuals who failed first‐line treatment were transferred to the PD state. The model was run from the time individuals were randomly assigned to receive treatment. Details of the transfer between the various states of the model were shown in Figure S1. The model consists of three independent states: progression‐free survival (PFS), progressive disease (PD), and death. ![]() A Markov model was built for the long‐term survival simulation of the target cohort. In this study, efficacy and safety data for the pembrolizumab plus chemotherapy regimen were collected from the KEYNOTE 590. This study, which is based on a phase III study (KEYNOTE‐590), evaluated the cost‐effectiveness of pembrolizumab plus chemotherapy versus fluorouracil plus platinum drugs as the first‐line treatment for advanced esophageal cancer. ![]() Excessive treatment costs may prompt patients to abandon optimal treatment options so, it is critical to strike a balance between cost and efficacy. ![]() This combination treatment regimen significantly improved the prognosis and corresponding objective outcomes in patients with esophageal cancer.Īlthough some literatures have demonstrated that pembrolizumab combined with chemotherapy has a greater therapeutic benefit than chemotherapy alone, it simultaneously carries a significant economic burden. In a phase 3 study (KEYNOTE‐590), the ICIplus chemotherapy for advanced esophageal cancer for the first‐line treatment showed better antitumor activity than chemotherapy alone. Studies have confirmed that immune site inhibitors can enhance the anti‐tumor activity of immune cells by blocking the programmed cell death protein 1(PD‐1) pathway, and combining chemotherapy with immune checkpoint inhibitors (ICIs) is gradually becoming the preferred option for the treatment of various cancers. This calls for a new and effective treatment regimen for patients whose disease course is still progressing after first‐line chemotherapy. The current top‐line drug treatment intervention for patients with advanced, or recurrent esophageal cancer is fluorouracil plus platinum drugs however, some patients still have poor survival improvement and present with further disease progression, and while drugs such as doxorubicin and paclitaxel have been attempted in such patients, the results remain unsatisfactory. The risk factors for esophageal adenocarcinoma are somewhat different from those for esophageal squamous cell carcinoma in particular, gastroesophageal reflux (GERD), Barrett's esophagus (BE), obesity, and alcohol are more independent risk factors for esophageal adenocarcinoma. There are several risk factors for esophageal cancer, including age and smoking. In 2019, approximately 17,000 people in the United States were diagnosed with esophageal cancer, accounting for nearly 1.0% of all new cases worldwide.Įsophageal adenocarcinoma is the most common histologic subtype in North America, and more men than women are affected. Esophageal cancer is the eighth most common cancer globally and its incidence continue to increase annually.
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