Sacituzumab govitecan plus pembrolizumab for advanced triple-negative breast cancer with PD-L1-positive: a cost-effectiveness analysis.
9 affiliations
- 1Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China.
- 2Department of Oncology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, 415000, People's Republic of China.
- 3Department of Oncology, Hunan Institute of Schistosomiasis Control (The Third People's Hospital of Hunan Province), Yueyang, 414000, People's Republic of China.
- 4Department of Urology I, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China.
- 5Gastroenterology Department II, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, 410013, People's Republic of China.
- 6Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China. [email protected].
- 7Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China. [email protected].
- 8Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China. [email protected].
- 9Department of Oncology, Hunan Institute of Schistosomiasis Control (The Third People's Hospital of Hunan Province), Yueyang, 414000, People's Republic of China. [email protected].
Abstract
Background
Therapeutic options for patients with poor-prognosis invasive triple-negative breast cancer (TNBC) remain lacking. Although novel treatment strategies have demonstrated improved efficacy, they are frequently associated with substantial financial costs. Consequently, rigorous economic evaluation is essential to inform clinical and policy decisions.Methods
A three-state Markov model with a lifetime horizon was developed using clinical efficacy data from the ASCENT-04/KEYNOTE-D19 trial, along with treatment-related cost inputs. Lifetime costs and health outcomes in cases of advanced TNBC for patients undergoing treatment with either sacituzumab govitecan plus pembrolizumab or chemotherapy plus pembrolizumab were estimated with the developed model. Model uncertainty and structural stability were examined via probabilistic and deterministic sensitivity analyses. Total costs, quality-adjusted life-years (QALYs), incremental net health benefit (INHB), incremental net monetary benefit (INMB), and incremental cost-effectiveness ratios (ICERs) were examined at a willingness-to-pay (WTP) threshold of $150,000/QALY in the USA.Results
The estimated lifetime cost was $1,831,187 for sacituzumab govitecan plus pembrolizumab and $574,011 for chemotherapy plus pembrolizumab. Corresponding health outcomes were 5.28 QALYs and 4.74 QALYs, respectively. The resulting ICER was $2,323,487 per QALY gained. The INHB and INMB were -7.84 QALYs and -$1,176,175, respectively. The most influential variables in the model included the utility value assigned to progression-free survival, patient body weight, and the cost-effectivness of sacituzumab govitecan. Sensitivity analysis demonstrated that the model findings were robust.Conclusions
At current market prices, sacituzumab govitecan plus pembrolizumab showed limited cost-effectiveness as a first-line option relative to chemotherapy plus pembrolizumab for treating advanced TNBC.
Related
- Sacituzumab govitecan plus toripalimab compared with toripalimab plus nab-paclitaxel for first-line treatment of unresectable, locally advanced, or metastatic triple-negative breast cancer: protocol of a multicenter, open-label, randomized phase II trial
- 514 Initial clinical results from START-002: a phase 1b/2 study of invikafusp alfa, a first-in-class dual T-cell agonist, in combination with sacituzumab govitecan in triple-negative or HR+/HER2- mBC
- TroFuse-032 study design: pembrolizumab plus sacituzumab tirumotecan or chemotherapy followed by pembrolizumab plus chemotherapy as neoadjuvant therapy for early-stage, triple-negative breast cancer or HR-low+/HER2− breast cancer
- Comparative Safety Profiles of Sacituzumab Govitecan and Datopotamab Deruxtecan: A Real-World Pharmacovigilance Study
- Efficacy and safety of sacituzumab govitecan in metastatic breast cancer: a single-center retrospective cohort study
BibTeX
@article{liu2026sacituzumab,
title = {{Sacituzumab govitecan plus pembrolizumab for advanced triple-negative breast cancer with PD-L1-positive: a cost-effectiveness analysis.}},
author = {Binliang Liu and Tao Wu and Fang Xu and Dongmei Sun and Yu Tang and Can Tian and Liping Liu and Zheyu Hu and Quchang Ouyang and Ning Xie},
journal = {Health economics review},
year = {2026},
month = jul,
doi = {10.1186/s13561-026-00824-x},
url = {https://europepmc.org/article/MED/42900283},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Sacituzumab govitecan plus pembrolizumab for advanced triple-negative breast cancer with PD-L1-positive: a cost-effectiveness analysis.
AU - Binliang Liu
AU - Tao Wu
AU - Fang Xu
AU - Dongmei Sun
AU - Yu Tang
AU - Can Tian
AU - Liping Liu
AU - Zheyu Hu
AU - Quchang Ouyang
AU - Ning Xie
PY - 2026
DA - 2026/07/01
JO - Health economics review
DO - 10.1186/s13561-026-00824-x
UR - https://europepmc.org/article/MED/42900283
AB - Background Therapeutic options for patients with poor-prognosis invasive triple-negative breast cancer (TNBC) remain lacking. Although novel treatment strategies have demonstrated improved efficacy, they are frequently associated with substantial financial costs. Consequently, rigorous economic evaluation is essential to inform clinical and policy decisions.Methods A three-state Markov model with a lifetime horizon was developed using clinical efficacy data from the ASCENT-04/KEYNOTE-D19 trial, along with treatment-related cost inputs. Lifetime costs and health outcomes in cases of advanced TNBC for patients undergoing treatment with either sacituzumab govitecan plus pembrolizumab or chemotherapy plus pembrolizumab were estimated with the developed model. Model uncertainty and structural stability were examined via probabilistic and deterministic sensitivity analyses. Total costs, quality-adjusted life-years (QALYs), incremental net health benefit (INHB), incremental net monetary benefit (INMB), and incremental cost-effectiveness ratios (ICERs) were examined at a willingness-to-pay (WTP) threshold of $150,000/QALY in the USA.Results The estimated lifetime cost was $1,831,187 for sacituzumab govitecan plus pembrolizumab and $574,011 for chemotherapy plus pembrolizumab. Corresponding health outcomes were 5.28 QALYs and 4.74 QALYs, respectively. The resulting ICER was $2,323,487 per QALY gained. The INHB and INMB were -7.84 QALYs and -$1,176,175, respectively. The most influential variables in the model included the utility value assigned to progression-free survival, patient body weight, and the cost-effectivness of sacituzumab govitecan. Sensitivity analysis demonstrated that the model findings were robust.Conclusions At current market prices, sacituzumab govitecan plus pembrolizumab showed limited cost-effectiveness as a first-line option relative to chemotherapy plus pembrolizumab for treating advanced TNBC.
SN - 2191-1991
ER -