The Health Impact of Using Anti-PD-1 Agents to Treat Early-Stage Cancer in Belgium

INTRODUCTION: Anti-PD-1 agents, inhibitors of programmed cell death protein 1 (PD-1), significantly improve clinical outcomes and overall survival for individuals with several metastatic and early-stage cancers. This study evaluates the health impact of using anti-PD-1 agents for early-stage disease (ESD) treatment of melanoma (stage IIB-C and III), renal cell carcinoma (RCC), and triple-negative breast cancer (TNBC) in Belgium (2023-2032). METHODS: Belgian individuals eligible for ESD treatment (target population) entered a Markov-based health outcomes model in a recurrence/event/disease-free state. The model compared anti-PD-1 agents only for metastatic disease treatment (reference scenario) versus anti-PD-1 agents for ESD treatment (ESD scenario) from 2023 to 2032. Clinical outcomes of the model included recurrence/event/disease-free life-years (LYs), total LYs, quality-adjusted LYs (QALYs), recurrences/events, active treatments for metastatic disease, and total deaths. The cumulative health impact of ESD anti-PD-1 treatment in Belgium was calculated as the difference in health outcomes between the ESD and reference scenarios for the time horizon. RESULTS: Of the 14,306 eligible individuals, 11,065 were predicted to initiate treatment with anti-PD-1 agents for ESD. Anti-PD-1 therapies for ESD increased recurrence/event/disease-free LYs (+13.4%), total LYs (+4.4%), and QALYs (+4.9%) after 10 years. Additionally, ESD treatment decreased recurrences/events (-24.6%), active treatments for metastatic disease (-28.6%), and total deaths (-23.8% decrease) over 10 years. CONCLUSIONS: The investment in and use of innovative anti-PD-1 agents for the treatment of early-stage cancers would have a positive health impact for Belgium and align with the high standards in cancer care called for in Europe's Beating Cancer Plan.