{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:00:49Z","timestamp":1785301249095,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GLAXOSMITHKLINE, S.A."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Objectives: To estimate the added value of dostarlimab compared to durvalumab and pembrolizumab as first-line treatment for adult patients with primary advanced or recurrent endometrial cancer (EC) in Spain using a Multi-Criteria Decision Analysis (MCDA) framework. Methods: Following the Evidence and Value: Impact on Decision Making (EVIDEM) framework and International Society for Pharmacoeconomics and Outcomes Research (ISPOR) recommendations, 25 Spanish experts (12 medical oncologists and 13 hospital pharmacists) weighted and scored 11 quantitative and 5 qualitative criteria based on an evidence matrix from a literature review. Results: Efficacy and safety were weighted as the most important criteria. Dostarlimab showed positive added value in both comparisons with scores of 0.58 versus durvalumab\/durvalumab + olaparib and 0.50 versus pembrolizumab. Dostarlimab and pembrolizumab are the only therapies reimbursed in the Spanish public health system; therefore, their comparative assessment is of clinical and strategic relevance. While pembrolizumab may show longer progression-free survival (PFS) and response duration in specific subgroups, the evidence for dostarlimab\u2014including a statistically significant improvement in overall survival (OS) in the overall population as a primary endpoint, more robust data, and favorable long-term quality-of-life outcomes\u2014was considered by the expert panel to support a more favorable assessment. Conclusions: Within the MCDA framework, experts consider dostarlimab an option with a higher value contribution for adult patients with primary advanced or recurrent EC. Its clinical benefits, improved quality-of-life outcomes, and alignment with healthcare priorities promote treatment continuity and adherence in clinical practice. MCDA provided a transparent approach for multidimensional evaluation of these therapies.<\/jats:p>","DOI":"10.3390\/jcm15155808","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:47:41Z","timestamp":1785145661000},"page":"5808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Contribution of Dostarlimab to First-Line Treatment of Advanced or Recurrent Endometrial Cancer in Spain: A Multi-Criteria Decision Analysis Approach"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0074-6614","authenticated-orcid":false,"given":"Maria-Pilar","family":"Barretina-Ginesta","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Institut Catal\u00e0 d\u2019Oncologia (ICO), Girona Biomedical Research Institute (IDIBGI), Department of Medical Sciences, Medical School University of Girona (UdG), 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Mart\u00edn","family":"Lorente","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, University Hospital Santa Creu i Sant Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4051-3965","authenticated-orcid":false,"given":"Constanza","family":"Maximiano","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Puerta de Hierro\u2013Segovia de Arana Health Research Institute (IDIPHISA), University Hospital Puerta de Hierro, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9627-5337","authenticated-orcid":false,"given":"Ra\u00fal","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Pharmacy Department, University Hospital of Getafe, 28905 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EC-MCDA Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"As\u00eds","family":"Ariznavarreta","sequence":"additional","affiliation":[{"name":"Outcomes\u201910 (a ProductLife Group Company), 12071 Castell\u00f3n de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1887-4485","authenticated-orcid":false,"given":"Ana","family":"Calvo","sequence":"additional","affiliation":[{"name":"Outcomes\u201910 (a ProductLife Group Company), 12071 Castell\u00f3n de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Soler","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Institut Catal\u00e0 d\u2019Oncologia (ICO), 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","unstructured":"Mahdy, H., Vadakekut, E.S., and Crotzer, D. (2025, September 01). Endometrial Cancer 2024, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK525981\/."},{"key":"ref_2","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_3","unstructured":"Sociedad Espa\u00f1ola de Oncolog\u00eda M\u00e9dica SEOM (2026, February 09). Las Cifras del C\u00e1ncer en Espa\u00f1a 2026. Available online: https:\/\/seom.org\/images\/Las_Cifras_del_Cancer_en_Espanya_2026.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.annonc.2022.05.009","article-title":"Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"33","author":"Oaknin","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1056\/NEJMoa2216334","article-title":"Dostarlimab for Primary Advanced or Recurrent Endometrial Cancer","volume":"388","author":"Mirza","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1038\/s41572-021-00324-8","article-title":"Endometrial cancer","volume":"7","author":"Makker","year":"2021","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/nature12113","article-title":"Integrated genomic characterization of endometrial car-cinoma","volume":"497","author":"Kandoth","year":"2013","journal-title":"Nature"},{"key":"ref_8","unstructured":"Aemps, M. (2025, November 01). Informe de Posicionamiento Terap\u00e9utico de Dostarlimab (Jemperli\u00ae) en Combinaci\u00f3n con Carboplatino y Paclitaxel para el Tratamiento de Pacientes Adultas con C\u00e1ncer de Endometrio Avanzado de Nuevo Diagn\u00f3stico o en Reca\u00edda con Deficiencia del Sistema de Reparaci\u00f3n de Apareamientos Err\u00f3neos(dMMR)\/Inestabilidad de Microsat\u00e9lites alta (MSI-H), y que son Candidatas a Terapia Sist\u00e9mica. Available online: https:\/\/www.aemps.gob.es\/medicamentosUsoHumano\/informesPublicos\/docs\/2024\/IPT-317-Jemperli-dostarlimab.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1002\/cncr.35030","article-title":"Characterization of mismatch-repair\/microsatellite instability-discordant endometrial cancers","volume":"130","author":"Riedinger","year":"2023","journal-title":"Cancer"},{"key":"ref_10","unstructured":"Sociedad Espa\u00f1ola de Oncolog\u00eda M\u00e9dica (SEOM) (2025, October 01). Informe de Evaluaci\u00f3n SEOM de Lynparza (Olaparib) e Imfinzi (Durvalumab) en C\u00e1ncer Endometrio Avanzado de Nuevo Diagn\u00f3stico o Recurrente. Available online: https:\/\/seom.org\/seomcms\/images\/stories\/Informes_SEOM\/IEV_SEOM_DUO-E.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3841","DOI":"10.1200\/JCO.20.01076","article-title":"Carboplatin and Paclitaxel for Advanced Endometrial Cancer: Final Overall Survival and Adverse Event Analysis of a Phase III Trial (NRG Oncology\/GOG0209)","volume":"38","author":"Miller","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S564","DOI":"10.1016\/j.annonc.2024.08.804","article-title":"743P Immunotherapy plus chemotherapy in the first-line treatment for primary advanced or recurrent endometrial cancer: An extracted individual patient data and trial-level meta-analysis","volume":"35","author":"Gouveia","year":"2024","journal-title":"Ann. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104555","DOI":"10.1016\/j.critrevonc.2024.104555","article-title":"First-line treatments for advanced or recurrent endo-metrial cancer: Systematic literature review of clinical evidence","volume":"206","author":"Mirza","year":"2025","journal-title":"Crit. Rev. Oncol."},{"key":"ref_14","unstructured":"EMA (2025, July 01). Jemperli (Dostarlimab). Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/jemperli."},{"key":"ref_15","unstructured":"EMA (2026, January 09). Keytruda (Pembrolizumab). Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/keytruda."},{"key":"ref_16","unstructured":"EMA (2026, January 09). Imfinzi (Durvalumab). Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/imfinzi."},{"key":"ref_17","unstructured":"AEMPS (2026, January 12). Ficha T\u00e9cnica Lynparza, Available online: https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/114959004\/FT_114959004.html#5."},{"key":"ref_18","unstructured":"AEMPS (2026, January 12). Ficha T\u00e9cnica Jemperli, Available online: https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/1211538001\/FT_1211538001.html."},{"key":"ref_19","unstructured":"AEMPS (2026, January 12). Ficha T\u00e9cnica Keytruda, Available online: https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/1151024002\/FT_1151024002.html."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1586\/17512433.2015.990380","article-title":"Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?","volume":"8","author":"Godman","year":"2015","journal-title":"Expert Rev. Clin. Pharmacol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1360545","DOI":"10.1080\/20016689.2017.1360545","article-title":"Utilization of multiple-criteria decision analysis (MCDA) to support healthcare decision-making FIFARMA, 2016","volume":"5","author":"Drake","year":"2017","journal-title":"J. Mark. Access Health Policy"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s40259-018-0284-3","article-title":"Determining the Value of Two Biologic Drugs for Chronic Inflammatory Skin Diseases: Results of a Multi-Criteria Decision Analysis","volume":"32","author":"Zozaya","year":"2018","journal-title":"BioDrugs"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jval.2016.11.011","article-title":"Using Multicriteria Approaches to Assess the Value of Health Care","volume":"20","author":"Phelps","year":"2017","journal-title":"Value Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1186\/s12913-018-3367-4","article-title":"Strengthening the evidence-base of integrated care for people with multi-morbidity in Europe using Multi-Criteria Decision Analysis (MCDA)","volume":"18","author":"Leijten","year":"2018","journal-title":"BMC Health Serv. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/1758-5899.12387","article-title":"Resource allocation and priority setting in health care: A multi-criteria decision analysis problem of value?","volume":"8","author":"Angelis","year":"2017","journal-title":"Glob. Policy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1080\/21678707.2019.1652163","article-title":"Development and validation of an MCDA framework for evaluation and decision-making of orphan drugs in Spain","volume":"7","author":"Badia","year":"2019","journal-title":"Expert Opin. Orphan Drugs"},{"key":"ref_27","unstructured":"Zozaya, N., Moreno, J.O., and Vega, \u00c1.H. (2018). Multi-Criteria Decision Analysis in Healthcare: Its Usefulness and Limitations for Decision Making, Fundaci\u00f3n Weber."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13023-019-1121-6","article-title":"Implementing reflective multicriteria decision analysis (MCDA) to assess orphan drugs value in the Catalan Health Service (CatSalut)","volume":"14","author":"Guarga","year":"2019","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1017\/S0266462317000149","article-title":"Drug Evaluation and Deci-Sion Making in Catalonia: Development and Validation of a Methodological Framework Based on Multi-Criteria Decision Analysis (MCDA) for Orphan Drugs","volume":"33","author":"Catalan","year":"2017","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1080\/14737167.2022.2019580","article-title":"Multicriteria decision analysis in health care decision in oncology: A systematic review","volume":"22","author":"Campolina","year":"2022","journal-title":"Expert Rev. Pharmacoecon. Outcomes Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s41669-017-0048-x","article-title":"Applying a Multicriteria Decision Analysis (MCDA) Approach to Elicit Stakeholders\u2019 Preferences in Italy: The Case of Obinutuzumab for Rituximab-Refractory Indolent Non-Hodgkin Lymphoma (iNHL)","volume":"2","author":"Garau","year":"2018","journal-title":"PharmacoEconomics-Open"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.jval.2022.11.007","article-title":"The Use of Multicriteria Decision Analysis to Support Decision Making in Healthcare: An Updated Systematic Literature Review","volume":"26","author":"Rocks","year":"2023","journal-title":"Value Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s40273-014-0135-0","article-title":"Assessing the value of healthcare interventions using multi-criteria decision analysis: A review of the literature","volume":"32","author":"Marsh","year":"2014","journal-title":"Pharmacoeconomics"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Hsu, J.C., Lin, J.-Y., Lin, P.-C., and Lee, Y.-C. (2019). Comprehensive value assessment of drugs using a multi-criteria decision analysis: An example of targeted therapies for metastatic colorectal cancer treatment. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0225938"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s12325-017-0653-1","article-title":"Development of a framework based on reflective MCDA to support patient\u2013clinician shared decision-making: The case of the management of Gastroenteropancreatic Neuro-endocrine Tumors (GEP-NET) in the United States","volume":"35","author":"Wagner","year":"2018","journal-title":"Adv. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e298","DOI":"10.1200\/JOP.19.00487","article-title":"Development of a multicriteria decision analysis framework for evaluating and positioning oncologic treatments in clinical practice","volume":"16","author":"Camps","year":"2020","journal-title":"JCO Oncol. Pract."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e00045517","DOI":"10.1590\/0102-311x00045517","article-title":"An\u00e1lise de decis\u00e3o multicrit\u00e9rio para aloca\u00e7\u00e3o de recursos e avalia\u00e7\u00e3o de tecnologias em sa\u00fade: T\u00e3o longe e t\u00e3o perto?","volume":"33","author":"Campolina","year":"2017","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e025752","DOI":"10.1136\/bmjopen-2018-025752","article-title":"Development and pilot of a multicriteria decision analysis (MCDA) tool for health services administrators","volume":"9","author":"Blythe","year":"2019","journal-title":"BMJ Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1111\/hex.12287","article-title":"Application of multicriteria decision analysis in health care: A systematic review and bibliometric analysis","volume":"18","author":"Adunlin","year":"2015","journal-title":"Health Expect."},{"key":"ref_40","first-page":"e622","article-title":"The direct and indirect financial costs of informal cancer care: A scoping review","volume":"27","author":"Coumoundouros","year":"2019","journal-title":"Health Soc. Care Commun."},{"key":"ref_41","first-page":"14","article-title":"A multicriteria decision analysis (MCDA) applied to three long-term prophylactic treatments for hereditary angioedema in Spain","volume":"9","author":"Zozaya","year":"2022","journal-title":"Glob. Reg. Health Technol. Assess."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2567970","DOI":"10.1080\/20523211.2025.2567970","article-title":"Value contribution of trifluridine\/tipiracil with bevacizumab for the treatment of metastatic colorectal cancer in Catalonia using a multicriteria decision analysis","volume":"18","author":"Calle","year":"2025","journal-title":"J. Pharm. Policy Pract."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1080\/14737167.2022.2063842","article-title":"Assessing the value contribution of bimekizumab for the treatment of moderate-to-severe psoriasis using a multidisciplinary reflective multi-criteria decision analysis","volume":"22","author":"Zozaya","year":"2022","journal-title":"Expert Rev. Pharmacoecon. Outcomes Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jval.2015.12.003","article-title":"Multiple Criteria Decision Analysis for Health Care Decision Making\u2014An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force","volume":"19","author":"Thokala","year":"2016","journal-title":"Value Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1111\/hex.12178","article-title":"Multicriteria decision analysis in oncology","volume":"18","author":"Adunlin","year":"2015","journal-title":"Health Expect."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Wagner, M., Khoury, H., Bennetts, L., Berto, P., Ehreth, J., Badia, X., and Goetghebeur, M. (2017). Appraising the holistic value of Lenvatinib for radio-iodine refractory differentiated thyroid cancer: A multi-country study applying pragmatic MCDA. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3258-9"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/s13023-018-0966-4","article-title":"Determining the value contribution of selexipag for the treatment of pulmonary arterial hypertension (PAH) in Spain using reflective multi-criteria decision analysis (MCDA)","volume":"13","author":"Ais","year":"2018","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Tony, M., Wagner, M., Khoury, H., Rindress, D., Papastavros, T., Oh, P., and Goetghebeur, M.M. (2011). Bridging health technology assessment (HTA) with multicriteria decision analyses (MCDA): Field testing of the EVIDEM framework for coverage decisions by a public payer in Canada. BMC Health Serv. Res., 11.","DOI":"10.1186\/1472-6963-11-329"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1478-7547-8-4","article-title":"Combining multicriteria decision analysis, ethics and health technology assessment: Applying the EVIDEM decisionmaking framework to growth hormone for Turner syndrome patients","volume":"8","author":"Goetghebeur","year":"2010","journal-title":"Cost Eff. Resour. Alloc."},{"key":"ref_50","first-page":"107","article-title":"Determining the value contribution of emicizumab (Hemlibra\u00ae) for the prophylaxis of haemophilia A with inhibitors in Spain by multi-criteria decision analysis","volume":"6","author":"Poveda","year":"2019","journal-title":"Glob. Reg. Health Technol. Assess."},{"key":"ref_51","unstructured":"(2026, January 12). BIFIMED. Ministerio de Sanidad. Available online: https:\/\/www.sanidad.gob.es\/eu\/profesionales\/medicamentos.do."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.socscimed.2017.06.024","article-title":"Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology As-sessment and beyond: The Advance Value Framework","volume":"188","author":"Angelis","year":"2017","journal-title":"Soc. Sci. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1017\/S0266462316000350","article-title":"Testing multi-criteria decision analysis for more transparent re-source-allocation decision making in Colombia","volume":"32","author":"Jaramillo","year":"2016","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5152\/balkanmedj.2015.15185","article-title":"Criteria for Drug Reimbursement Decision-Making: An Emerging Public Health Challenge in Bulgaria","volume":"33","author":"Iskrov","year":"2016","journal-title":"Balk. Med. J."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.jval.2012.04.001","article-title":"Decision-making criteria among national policymakers in five countries: A discrete choice experiment eliciting relative preferences for equity and efficiency","volume":"15","author":"Mirelman","year":"2012","journal-title":"Value Health"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s44337-024-00062-2","article-title":"The efficacy and safety of pembrolizumab and dostarlimab in advanced en-dometrial carcinoma: A systematic review","volume":"1","author":"Kokori","year":"2024","journal-title":"Discov. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1136\/ijgc-2024-005296","article-title":"Immune checkpoint inhibitor combinations for patients with advanced endometrial cancer: A network meta-analysis and cost-utility analysis","volume":"34","author":"Zhu","year":"2024","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.3802\/jgo.2025.36.e6","article-title":"Immunotherapy plus chemotherapy in patients with advanced endometrial cancer: A cost-effectiveness analysis","volume":"36","author":"Zhu","year":"2024","journal-title":"J. Gynecol. Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"101761","DOI":"10.1016\/j.gore.2025.101761","article-title":"Cost-effectiveness of chemotherapy in advanced and recurrent endometrial cancer","volume":"59","author":"Inami","year":"2025","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_60","unstructured":"(2026, January 12). Acuerdos de la Comisi\u00f3n Interministerial de Precios de los Medicamentos Sesi\u00f3n 265. Ministerio de Sanidad. Available online: https:\/\/www.sanidad.gob.es\/areas\/farmacia\/precios\/comisionInteministerial\/acuerdosNotasInformativas\/docs\/Acuerdos_CIPM_265.pdf."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s40273-015-0370-z","article-title":"Value-Based Assessment of New Medical Technologies: Towards a Robust Methodological Framework for the Application of Multiple Criteria Decision Analysis in the Context of Health Technology Assessment","volume":"34","author":"Angelis","year":"2016","journal-title":"Pharmacoeconomics"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1017\/S0266462321001719","article-title":"Building a model of health technology assessment cooperation: Lessons learned from EUnetHTA joint action 3","volume":"38","author":"Garrett","year":"2022","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1017\/S0266462323000077","article-title":"Stakeholder perspectives on cooperation in the clinical and nonclinical health technology assessment domains","volume":"39","author":"Zimmermann","year":"2023","journal-title":"Int. J. Technol. Assess. Health Care"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5808\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:20:26Z","timestamp":1785298826000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":63,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15155808"],"URL":"https:\/\/doi.org\/10.3390\/jcm15155808","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]}}}