Presentation (CTI)

OBJECTIVES: The upcoming Belgian Cancer Plan 2025-2030 seeks to improve cancer care, partly by increasing early diagnoses and access to innovation. Better outcomes from early diagnosis hinge on rapid, effective treatment. As individualized neoantigen therapies (INTs) are being investigated for various cancers with promising early results, understanding their potential long-term impact is crucial. We estimated potential health, productivity, and health system capacity outcomes of introducing INTs for patients with resected melanoma in Belgium.
METHODS: A four-state Markov model with weekly cohort entry included patients with resected Stage IIIB-IV melanoma and compared outcomes over 10 years for two scenarios: (a) INTs may be used as adjuvant treatment, and (b) only traditional adjuvant treatments are available. Inputs included clinical trial data, national epidemiology statistics, and market share estimates.
RESULTS: Over 10 years, 1,781 of the 2,985 patients eligible for adjuvant therapy for melanoma were estimated to initiate treatment with INTs (instead of traditional treatments). This is anticipated to increase eligible population life years (LYs) without recurrence by 681 (7%) and quality-adjusted life years (QALYs) by 304 (3%), while avoiding 225 (15%) recurrences, 173 (11%) patients from requiring metastatic treatment and 102 (14%) deaths. It is also anticipated to result in 2,014 (11%) fewer intravenous metastatic treatment administrations needed, and a gain of 851 (11%) productive years for both patients and caregivers.
CONCLUSIONS: INTs currently in development have the potential to bring substantial health outcome benefits. Additionally, by increasing recurrence-free and overall survival, INTs can help lower absenteeism, resulting in work productivity gains. Finally, introducing INTs as an adjuvant treatment option has the potential to reduce the number of metastatic treatment administrations required, alleviating the associated cost for INAMI/RIZIV.