OBJECTIVES: It is estimated that 45,000 new cases of all cancers and 17,300 deaths due to cancer occur in Switzerland every year (1). A health outcomes projection model, used in Belgium, was adapted to Switzerland to assess the health benefits of adopting PD-(L)1 inhibitors in multiple early-stage cancers. Two scenarios were developed to compare health outcomes: a) PD-(L)1 inhibitors can be used for patients with early-stage disease (world with PD-(L)1 inhibitors) vs b) PD(L)1 inhibitors are reserved for patients who develop advanced/ metastatic disease (world without PD-(L)1 inhibitors for early-stage disease).

METHODS: The health outcomes model focuses on 3 cancers: melanoma, renal cell carcinoma (RCC), and triple-negative breast cancer (TNBC). The model predicts clinical outcomes throughout the average patient pathway in weekly cycles from when they initiate neoadjuvant and/or adjuvant treatment, over a time horizon of 10 years. Clinical outcomes estimated include life-years (LY), quality-adjusted life-years (QALY), events or recurrences, active treatments for metastatic disease, adverse events (AE), and deaths. The model leverages cost-effectiveness and budget impact models developed for HTA purposes, data from pivotal trials, and Swiss specific data on projected eligible patients and market shares (2-6).

RESULTS: Of the estimated 10,659 eligible patients over 10 years (2022-2031), 9,050 are estimated to initiate neoadjuvant and/or adjuvant treatment with PD-(L)1 inhibitors for early treatment for melanoma, RCC, and TNBC. Compared to PD-(L)1s being available only in the metastatic setting, introducing PD-(L)1 inhibitors in the neoadjuvant and/or adjuvant setting for melanoma, RCC, and TNBC is anticipated to:

• Avoid 1,144 recurrences (27%).
• Prevent 1,339 (33%) active treatments in the metastatic setting.
• Avoid 605 (29%) deaths.
• Increase Life Years without recurrence by 3,416 (10%).

CONCLUSIONS: Results suggest a potential benefit in preventing metastatic disease treatments, recurrences, and in deaths in Switzerland if PD-(L)1 inhibitors are used in the early stage of cancer treatment.