{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:54:30Z","timestamp":1793120070736,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with recurrent endometrial cancer treated with carboplatin and paclitaxel whose disease progresses have few effective treatment options. Based on promising clinical trial data, the anti\u2010programmed cell death\u20091 (anti\u2010PD\u20101) antibody dostarlimab was recently granted accelerated approval for endometrial cancer by the US Food and Drug Administration. We developed a decision model to examine the cost\u2010effectiveness of dostarlimab for patients with progressive\/recurrent deficient mismatch repair (dMMR) endometrial cancer whose disease has progressed with first\u2010line chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cost\u2010effectiveness study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Hypothetical cohort of 6000 women with progressive\/recurrent dMMR endometrial cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The initial decision point in the Markov model was treatment with dostarlimab, pembrolizumab or pegylated liposomal doxorubicin (PLD). Model probabilities, and cost and utility values were derived with assumptions drawn from published literature. Effectiveness was estimated as average quality\u2010adjusted life years (QALYs) gained. One\u2010way, two\u2010way and probabilistic sensitivity analyses were performed to vary the assumptions across a range of plausible values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary outcome was the incremental cost\u2010effectiveness ratio (ICER).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pegylated liposomal doxorubicin (PLD) was the least costly strategy, at $55,732, followed by dostarlimab ($151,533) and pembrolizumab ($154,597). Based on a willingness\u2010to\u2010pay threshold of $100,000\/QALY, PLD was cost\u2010effective compared with dostarlimab, with an ICER of $331,913 per QALY gained for dostarlimab, whereas pembrolizumab was ruled out by extended dominance (less effective, more costly), compared with dostarlimab. In one\u2010way sensitivity analyses, dostarlimab was cost\u2010effective when its cost was reduced to $4905 (52% reduction). These results were robust in a variety of sensitivity analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dostarlimab is associated with greater survival compared with other treatments for women with recurrent dMMR endometrial cancer. Although the agent is substantially more costly, dostarlimab became cost\u2010effective when its cost was reduced to $5489 per cycle.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17338","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T07:29:00Z","timestamp":1667546940000},"page":"214-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Dostarlimab for recurrent mismatch repair\u2010deficient endometrial cancer: A cost\u2010effectiveness study"],"prefix":"10.1111","volume":"130","author":[{"given":"Shayan","family":"Dioun","sequence":"first","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"New York Presbyterian Hospital New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Melamed","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Gockley","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caryn M.","family":"St. Clair","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June Y.","family":"Hou","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fady","family":"Khoury\u2010Collado","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin","family":"Hur","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Elkin","sequence":"additional","affiliation":[{"name":"Herbert Irving Comprehensive Cancer Center New York New York USA"},{"name":"Joseph L. 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