OBJECTIVES: This study aimed to compare the lifetime health outcome of sintilimab plus cisplatin and paclitaxel (SCP) versus cisplatin and paclitaxel (CP) as first-line treatment for advanced or metastatic Esophageal Squamous Cell Carcinoma (ESCC) in China.

METHODS: A 3 health states (progression-free survival, post-progression survival, and death) partitioned survival model was constructed using individual patient data of ORIENT-15 to simulate the lifetime health outcome from the perspective of the health care system. Clinical data was derived from ORIENT-15 and extrapolated using Log-Normal and Log-Logistic distribution. Utility values were elicited from EuroQol 5-dimension 5-level (EQ-5D-5L) assessed in ORIENT-15 using value set from China. Quality-adjusted life-year (QALY) and life year (LY) were primary outcomes and discounted at an annual rate of 5%. One-way sensitivity analysis was adopted to verify the robustness of the results. Survival analysis and simulation were completed in Stata SE 13 and MS Excel software.

RESULTS: Patients in the SCP group could survive for 1.94 years, of which progression-free survival (PFS) was 1.06 years, and progressive disease (PD) was 0.88 years. Meanwhile, Patients could gain a total of 1.74 QALYs, including 0.96 QALYs in PFS state and 0.78 QALYs in PD state. Patients in the CP group could survive for 1.43 years, of which the PFS was 0.66 years, and the PD was 0.76 years. Patients could gain a total of 1.23 QALYs, including 0.58 QALYs in PFS state and 0.65 QALYs in PD state. Compared with CP group, patients in the SCP group had 0.51 more years of survival and 0.51 more QALYs. One-way sensitivity analysis showed the results were generally robust

CONCLUSIONS: Compared with CP, first-line treatment of SCP for Chinese patients with advanced or metastatic ESCC could significantly prolong the survival time and improved the quality of life of patients.