scholarly journals Clinical and cost-effectiveness of capecitabine and tegafur with uracil for the treatment of metastatic colorectal cancer: systematic review and economic evaluation

2003 ◽  
Vol 7 (32) ◽  
Author(s):  
S Ward ◽  
E Kaltenthaler ◽  
J Cowan ◽  
N Brewer
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Metastatic Colorectal Cancer

A systematic review of cost-effectiveness of monoclonal antibodies for metastatic colorectal cancer

2014 ◽  
Vol 50 (1) ◽  
pp. 40-49 ◽  
Author(s):  
A. Lange ◽  
A. Prenzler ◽  
M. Frank ◽  
M. Kirstein ◽  
A. Vogel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Monoclonal Antibodies ◽  
Cost Effectiveness ◽  
Metastatic Colorectal Cancer

scholarly journals Cost-Effectiveness of RAS Genetic Testing Strategies in Patients With Metastatic Colorectal Cancer: A Systematic Review

2020 ◽  
Vol 23 (1) ◽  
pp. 114-126 ◽  
Author(s):  
Brigid Unim ◽  
Erica Pitini ◽  
Corrado De Vito ◽  
Elvira D’Andrea ◽  
Carolina Marzuillo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Genetic Testing ◽  
Cost Effectiveness ◽  
Metastatic Colorectal Cancer ◽  
Testing Strategies

scholarly journals KRAS mutation testing of tumours in adults with metastatic colorectal cancer: a systematic review and cost-effectiveness analysis

2014 ◽  
Vol 18 (62) ◽  
pp. 1-132 ◽  
Author(s):  
Marie Westwood ◽  
Thea van Asselt ◽  
Bram Ramaekers ◽  
Penny Whiting ◽  
Manuela Joore ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Metastatic Colorectal Cancer ◽  
Online Survey ◽  
Cost Effective ◽  
Mutation Testing ◽  
Standard Chemotherapy ◽  
The Uk ◽  
Quality Adjusted Life

BackgroundBowel cancer is the third most common cancer in the UK. Most bowel cancers are initially treated with surgery, but around 17% spread to the liver. When this happens, sometimes the liver tumour can be treated surgically, or chemotherapy may be used to shrink the tumour to make surgery possible. Kirsten rat sarcoma viral oncogene (KRAS) mutations make some tumours less responsive to treatment with biological therapies such as cetuximab. There are a variety of tests available to detect these mutations. These vary in the specific mutations that they detect, the amount of mutation they detect, the amount of tumour cells needed, the time to give a result, the error rate and cost.ObjectivesTo compare the performance and cost-effectiveness ofKRASmutation tests in differentiating adults with metastatic colorectal cancer whose metastases are confined to the liver and are unresectable and who may benefit from first-line treatment with cetuximab in combination with standard chemotherapy from those who should receive standard chemotherapy alone.Data sourcesThirteen databases, including MEDLINE and EMBASE, research registers and conference proceedings were searched to January 2013. Additional data were obtained from an online survey of laboratories participating in the UK National External Quality Assurance Scheme pilot forKRASmutation testing.MethodsA systematic review of the evidence was carried out using standard methods. Randomised controlled trials were assessed for quality using the Cochrane risk of bias tool. Diagnostic accuracy studies were assessed using the QUADAS-2 tool. There were insufficient data for meta-analysis. For accuracy studies we calculated sensitivity and specificity together with 95% confidence intervals (CIs). Survival data were summarised as hazard ratios and tumour response data were summarised as relative risks, with 95% CIs. The health economic analysis considered the long-term costs and quality-adjusted life-years associated with different tests followed by treatment with standard chemotherapy or cetuximab plus standard chemotherapy. The analysis took a ‘no comparator’ approach, which implies that the cost-effectiveness of each strategy will be presented only compared with the next most cost-effective strategy. The de novo model consisted of a decision tree and Markov model.ResultsThe online survey indicated no differences between tests in batch size, turnaround time, number of failed samples or cost. The literature searches identified 7903 references, of which seven publications of five studies were included in the review. Two studies provided data on the accuracy ofKRASmutation testing for predicting response to treatment in patients treated with cetuximab plus standard chemotherapy. Four RCTs provided data on the clinical effectiveness of cetuximab plus standard chemotherapy compared with that of standard chemotherapy in patients withKRASwild-type tumours. There were no clear differences in the treatment effects reported by different studies, regardless of whichKRASmutation test was used to select patients. In the ‘linked evidence’ analysis the Therascreen®KRASRGQ PCR Kit (QIAGEN) was more expensive but also more effective than pyrosequencing or direct sequencing, with an incremental cost-effectiveness ratio of £17,019 per quality-adjusted life-year gained. In the ‘assumption of equal prognostic value’ analysis the total costs associated with the various testing strategies were similar.LimitationsThe results assume that the differences in outcomes between the trials were solely the result of the different mutation tests used to distinguish between patients; this assumption ignores other factors that might explain this variation.ConclusionsThere was no strong evidence that any oneKRASmutation test was more effective or cost-effective than any other test.Study registrationPROSPERO CRD42013003663.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Cost-effectiveness of TAS-102 plus bevacizumab versus TAS-102 monotherapy in patients with metastatic colorectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kiyoaki Sugiura ◽  
Yuki Seo ◽  
Takayuki Takahashi ◽  
Hideyuki Tokura ◽  
Yasuhiro Ito ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Combination Therapy ◽  
Metastatic Colorectal Cancer ◽  
Cost Effective ◽  
Model Parameters ◽  
Combination Regimen ◽  
The Cost

Abstract Background TAS-102 plus bevacizumab is an anticipated combination regimen for patients who have metastatic colorectal cancer. However, evidence supporting its use for this indication is limited. We compared the cost-effectiveness of TAS-102 plus bevacizumab combination therapy with TAS-102 monotherapy for patients with chemorefractory metastatic colorectal cancer. Method Markov decision modeling using treatment costs, disease-free survival, and overall survival was performed to examine the cost-effectiveness of TAS-102 plus bevacizumab combination therapy and TAS-102 monotherapy. The Japanese health care payer’s perspective was adopted. The outcomes were modeled on the basis of published literature. The incremental cost-effectiveness ratio (ICER) between the two treatment regimens was the primary outcome. Sensitivity analysis was performed and the effect of uncertainty on the model parameters were investigated. Results TAS-102 plus bevacizumab had an ICER of $21,534 per quality-adjusted life-year (QALY) gained compared with TAS-102 monotherapy. Sensitivity analysis demonstrated that TAS-102 monotherapy was more cost-effective than TAS-102 and bevacizumab combination therapy at a willingness-to-pay of under $50,000 per QALY gained. Conclusions TAS-102 and bevacizumab combination therapy is a cost-effective option for patients who have metastatic colorectal cancer in the Japanese health care system.

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