David Barrington, MD, Gynecologic Oncology Fellowship, Ohio State University, OH, discusses results from a cost-effectiveness analysis of lenvatinib plus pembrolizumab in patients with recurrent endometrial cancer without microsatellite instability who failed first-line chemotherapy.

These results were presented at the 2021 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.

Transcript:  

Hi. I'm David Barrington. I'm a gynecologic oncology fellow at The Ohio State University, discussing our abstract, "Lenvatinib and Pembrolizumab in Advanced Recurrent, Microsatellite-Stable Endometrial Cancer: A Cost-Effectiveness Analysis." This data was presented at the Annual SGO Meeting on Women's Cancer.

The lenvatinib and pembrolizumab represents one of the most significant steps for treatment of recurrent endometrial cancer in the last 20 years or so. As opposed to single-agent therapy, it has the possibility of being broadly applicable for many recurrent endometrial cancers.

While it's very effective regimen, the data at the meeting also presented the results of a phase III trial comparing lenvatinib and pembrolizumab to treatment with standard chemotherapy. We sought to assess the cost-effectiveness of this treatment because we know this is an expensive and toxic regimen as well.

We wanted to design a model that incorporated that treatment toxicity and quality-of-life measures as well. While we didn't find in our model that treatment with lenvatinib and pembrolizumab for microsatellite-stable recurrent endometrial cancers was cost-effective relative to other treatments, we did identify that if side effects are effectively mitigated and limited, that improves the cost-effectiveness of this treatment.

In our opinion, these results shouldn't necessarily be viewed as an argument to limit the use of this effective therapy but as a call to think about ways we can more judiciously and efficaciously apply this treatment that we have as a high degree of toxicity and financial toxicity as well.

Our hope is that in the future, when more clinical biomarkers become more available, and we become more adept at managing toxicity, that we can continue to improve the cost-effectiveness of this exciting new therapy.