Presentation (CTI)

OBJECTIVES: The objective of this study was to estimate life years (LYs) and quality-adjusted life years (QALYs) of dostarlimab plus carboplatin and paclitaxel (CP) compared with standard CP-based chemotherapy for women with primary advanced or recurrent endometrial cancer (pA/R EC) with deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H), from the Brazilian public healthcare perspective.
METHODS: A three‑state partitioned survival model was developed (progression‑free disease, progressed disease, and death) to compare dostarlimab plus CP with CP alone, and a 5% annual discount rate was applied to long-term health outcomes. Clinical efficacy and safety data were informed by the Ruby trial (IA1 and IA2) and the survival extrapolations were constrained by age- and sex-adjusted Brazilian general population mortality. Health state utilities were estimated using EQ-5D-5L data from Ruby and adjusted to reflect age-specific quality of life in the Brazilian population and disutilities were applied for treatment‑related adverse events.
RESULTS: Over a lifetime horizon, dostarlimab plus CP achieved higher LYs and QALYs than CP alone, with 8.809 life‑years and 6.368 QALYs, compared with 3.204 life‑years and 2.323 QALYs, respectively. This corresponded to incremental gains of 5.605 life‑years and 4.045 QALYs driven by extended time in the progression‑free state in accordance with the most recent updated Ruby trial data in the dMMR/MSI-H pA/R EC population.
CONCLUSIONS: The findings demonstrate that dostarlimab plus CP provides a meaningful gain in LYs and QALYs for the treatment of women with dMMR/MSI-H pA/R EC. Within the context of Brazilian public healthcare, introducing this regimen may represent a significant advancement by addressing an unmet medical need, prolonging overall survival and offering a highly effective clinical alternative for a patient population with limited therapeutic options in the Brazilian public healthcare system.