{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:18:09Z","timestamp":1793823489123,"version":"4.6.1"},"reference-count":44,"publisher":"Harborside Press, LLC","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Recently, the CheckMate 067, KEYNOTE-006, and RELATIVITY-047 trials demonstrated the long-term efficacy and safety of 5 first-line therapies for advanced melanoma, including nivolumab + relatlimab, with &gt;10 years of follow-up. However, the long-term economic outcomes are still unclear. This study aimed to assess the comparative cost-effectiveness of these strategies from a US health care perspective using more than a decade of clinical trial data.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Based on the data from clinical trial reports, we simulated a cohort of 1,662 patients with advanced melanoma across 5 treatment groups in which patients received ipilimumab, nivolumab, pembrolizumab, nivolumab + ipilimumab, or nivolumab + relatlimab as first-line therapy. A flexible parametric survival model was used, combined with background mortality rates, to estimate patients\u2019 lifetime overall survival and progression-free survival. A partitioned survival model was constructed to assess the total cost, quality-adjusted life-years (QALYs), total life-years, and incremental cost-effectiveness ratios (ICERs) for the 5 treatment strategies. Sensitivity analyses, including univariate, probabilistic, scenario, and subgroup analyses, were conducted to evaluate the robustness of the model and population differences.\n                    <jats:bold>Results:<\/jats:bold>\n                    Nivolumab + ipilimumab provided the highest QALYs (7.30), followed by nivolumab + relatlimab (6.67 QALYs). Ipilimumab and nivolumab + relatlimab were associated with the lowest ($239,168) and highest ($471,610) costs, respectively. Compared with nivolumab, only nivolumab + ipilimumab resulted in ICERs below the willingness-to-pay threshold of $150,000\/QALY. Drug costs and body weight were the most influential factors affecting ICERs. Nivolumab + ipilimumab demonstrated the highest probability of being the most cost-effective strategy.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Among first-line immunotherapy strategies for advanced melanoma, nivolumab + ipilimumab and nivolumab + relatlimab provided the greatest survival benefits. After integrating treatment costs, safety, and health-related quality of life, nivolumab + ipilimumab was the most cost-effective strategy under base-case assumptions, followed by nivolumab monotherapy.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2026.7031","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:28:58Z","timestamp":1788445738000},"source":"Crossref","is-referenced-by-count":1,"title":["Comparative Cost-Effectiveness Analysis of First-Line Immunotherapy for Advanced Melanoma Based on 10-Year Clinical Outcomes"],"prefix":"10.6004","volume":"24","author":[{"given":"Guiyuan","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Daping Hospital, Army Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Sun","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Daping Hospital, Army Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Daping Hospital, Army Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"CA Cancer J Clin","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray F","year":"2024","unstructured":"Bray F, Laversanne M, Sung H,  Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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