Related Experiment Video
Updated: Jan 31, 2026

A Melanoma Patient-Derived Xenograft Model
Published on: May 20, 2019
Clinical and economic outcomes associated with treatment sequences in patients with BRAF-mutant advanced melanoma
Ahmad Tarhini1, David McDermott2, Apoorva Ambavane3
1Department of Hematology & Oncology, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, 44106, USA.
Aim:
The cost-effectiveness of treatment sequences in BRAF-mutant advanced melanoma.
Materials & Methods:
A discrete event simulation model was developed to estimate total costs and health outcomes over a patient's lifetime (30 years). Efficacy was based on the CheckMate 067/069 trials and a matching-adjusted-indirect comparison between immuno-oncology and targeted therapies. Safety, cost (in US dollars; US third-party payer perspective) and health-related quality-of-life inputs were based on published literature.
Results:
Estimated survival gain was higher for sequences initiating with anti-PD-1 + anti-CTLA-4 than for anti-PD-1 monotherapy or BRAF+MEK inhibitors. The incremental cost-effectiveness ratio per QALY gained for first-line anti-PD-1 + anti-CTLA-4 was US$54,273 versus first-line anti-PD-1 and $79,124 versus first-line BRAF+MEK inhibitors.
Conclusion:
Initiating treatment with anti-PD-1 + anti-CTLA-4 was more cost-effective than initiation with anti-PD-1 monotherapy or BRAF+MEK inhibitors.
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