KEY TAKEAWAYS
- The analysis of the phase 3 RUBY study aimed to calculate per-patient cost variations for grade ≥3 AEs with dostarlimab+CP versus placebo+CP.
- In the dMMR/MSI-H group, dostarlimab+CP had notably lower grade ≥3 TEAE and TRAE costs, supporting its use as standard care.
In the RUBY trial (NCT03981796), dostarlimab combined with carboplatin-paclitaxel (CP) notably extended progression-free survival (PFS) versus placebo+CP in pA/rEC patients. More grade ≥3 AEs were observed with dostarlimab+CP.
Based on the study, researchers examined the per-patient cost difference of grade ≥3 AEs between dostarlimab+CP and placebo+CP.
The model was based on severe treatment-related adverse events (AEs) from RUBY part 1, estimated costs. It utilized 2020 hospitalization data to calculate management expenses. Mean per-patient costs for each AE were derived using these calculations.
Scenario analysis included determining the number needed to treat to harm or benefit (NNTH or NNTB) from the risk difference for each AE. These analyses were conducted within the dMMR/MSI-H and ITT populations.
In the dMMR/MSI-H group, aggregate per-patient costs were lower with dostarlimab+CP compared to placebo+CP for TEAEs ($26,968 vs $35,862) and TRAEs ($19,775 vs $26,005), respectively. The cost difference was influenced by managing neutrophil and white cell count decreases more frequent in the placebo group.
In the ITT population, per-patient costs were higher for dostarlimab+CP for TEAEs ($28,199 vs $25,219) and slightly higher for TRAEs ($19,375 vs $19,156), influenced by various adverse events. The scenario analysis showed similar AE cost differences.
In the dMMR/MSI-H group, grade ≥3 adverse event costs were expected to be notably reduced with dostarlimab+CP. In the overall population, grade ≥3 adverse event costs were projected slightly higher for dostarlimab+CP for TEAEs, while similar for TRAEs.
Considering the significant PFS benefits, these findings support dostarlimab+CP as a potential new standard of care, particularly for dMMR/MSI-H pA/rEC patients.
Source: https://jitc.bmj.com/content/11/Suppl_1/A668
Clinical Trial: https://clinicaltrials.gov/study/NCT03981796
Lubinga SJ, Payer T, Gregg M, et al588 Dostarlimab + chemotherapy for the treatment of primary advanced or recurrent endometrial cancer (pA/rEC) in the RUBY trial: post hoc analysis of the costs of grade ≥3 adverse events (AEs)Journal for ImmunoTherapy of Cancer 2023;11:doi: 10.1136/jitc-2023-SITC2023.0588
