| Sumario: | This article focuses on the pilot study conducted by the World Health Organization (WHO) Secretariat to apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision (EtD) framework for prioritizing PD-1 and PD-L1 immune checkpoint inhibitors on the WHO Model List of Essential Medicines (EML) for treating adults with solid tumors in the palliative first-line setting. The study adapted the EtD framework to evaluate 24 medicine-indication combinations across 12 cancer types, considering clinical benefits (overall survival, quality of life), harms, certainty of evidence, and additional factors such as cost-effectiveness, equity, acceptability, feasibility, and availability. Results showed variable survival benefits and evidence certainty, with high costs and limited accessibility posing challenges, especially in low- and middle-income countries. The EtD framework facilitated a transparent, standardized approach to support the WHO Expert Committee’s decision-making on essential cancer medicines, highlighting the need to balance clinical benefits with resource implications globally.
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