scholarly journals Early cost-effectiveness analysis of risk-based selection strategies for adjuvant treatment in stage II colon cancer: the potential value of prognostic molecular markers

2021 ◽  
pp. cebp.0078.2021
Author(s):  
Gabrielle Jongeneel ◽  
Marjolein JE Greuter ◽  
Natalia Kunst ◽  
Felice N van Erning ◽  
Miriam Koopman ◽  
...  
2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 3532-3532 ◽  
Author(s):  
S. Aballea ◽  
J. Chancellor ◽  
M. Raikou ◽  
M. Drummond ◽  
M. Weinstein ◽  
...  

2021 ◽  
Vol 14 ◽  
pp. 175628482199571
Author(s):  
Gabrielle Jongeneel ◽  
Marjolein J. E. Greuter ◽  
Felice N. van Erning ◽  
Miriam Koopman ◽  
Geraldine R. Vink ◽  
...  

Background: We aimed to evaluate the cost-effectiveness of risk-based strategies to improve the selection of surgically treated stage II colon cancer (CC) patients for adjuvant chemotherapy. Methods: Using the ‘Personalized Adjuvant TreaTment in EaRly stage coloN cancer’ (PATTERN) model, we evaluated five selection strategies: (1) no chemotherapy, (2) Dutch guideline recommendations assuming observed adherence, (3) Dutch guideline recommendations assuming perfect adherence, (4) biomarker mutation OR pT4 stage strategy in which patients with MSS status combined with a pT4 stage or a mutation in BRAF and/or KRAS receive chemotherapy assuming perfect adherence and (5) biomarker mutation AND pT4 stage strategy in which patients with MSS status combined with a pT4 stage tumor and a BRAF and/or KRAS mutation receive chemotherapy assuming perfect adherence. Outcomes were number of CC deaths per 1000 patients and total discounted costs and quality-adjusted life-years (QALYs) per patient (pp). Analyses were conducted from a societal perspective. The robustness of model predictions was assessed in sensitivity analyses. Results: The reference strategy, that is, no adjuvant chemotherapy, resulted in 139 CC deaths in a cohort of 1000 patients, 8.077 QALYs pp and total costs of €22,032 pp. Strategies 2–5 were more effective (range 8.094–8.217 QALYs pp and range 118–136 CC deaths per 1000 patients) and more costly (range €22,404–€25,102 pp). Given a threshold of €50,000/QALY, the optimal use of resources would be to treat patients with either the full adherence strategy and biomarker mutation OR pT4 stage strategy. Conclusion: Selection of stage II CC patients for chemotherapy can be improved by either including biomarker status in the selection strategy or by improving adherence to the Dutch guideline recommendations.


Cancer ◽  
2007 ◽  
Vol 109 (6) ◽  
pp. 1082-1089 ◽  
Author(s):  
Samuel Aballéa ◽  
Jeremy V.M. Chancellor ◽  
Maria Raikou ◽  
Michael F. Drummond ◽  
Milton C. Weinstein ◽  
...  

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