A descriptive cost-analysis of MYX.1/MCRN003, a phase 2 clinical trial evaluating high-dose weekly carfilzomib, cyclophosphamide, and dexamethasone in relapsed and refractory multiple myeloma.

Autor: Monteith BE; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada.; Cancer Center of Southeastern Ontario, Queen's University, Kingston, ON, Canada., Venner CP; The Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada., Cheung MC; Odette Cancer Centre, University of Toronto, Toronto, ON, Canada., Pater J; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada., Shepherd L; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada., Richardson H; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada., Reece D; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., Gul E; Canadian Myeloma Research Group (formerly the Myeloma Canada Research Network), Vaughan, ON, Canada., Lalancette M; CHU de Québec, Hôtel-Dieu de Québec, Université Laval, Quebec City, QC, Canada., Castonguay V; CHU de Québec, Hôtel-Dieu de Québec, Université Laval, Quebec City, QC, Canada., Kukreti V; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., Tiedemann R; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., Phua C; Victoria Hospital, Western University, London, ON, Canada., Bhella S; Cancer Center of Southeastern Ontario, Queen's University, Kingston, ON, Canada., Dudebout J; Cancer Center of Southeastern Ontario, Queen's University, Kingston, ON, Canada., Sherry M; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada., Yen H; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada., Chen BE; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada., Hay AE; Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada.; Cancer Center of Southeastern Ontario, Queen's University, Kingston, ON, Canada.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2021 Sep; Vol. 107 (3), pp. 333-342. Date of Electronic Publication: 2021 Jun 23.
DOI: 10.1111/ejh.13671
Abstrakt: Background: The prevalence of multiple myeloma is increasing and there is a need to evaluate escalating therapy costs (Canadian Cancer Statistics A, 2020). The MYX.1 phase II trial showed that high-dose weekly carfilzomib, cyclophosphamide, and dexamethasone (wKCD) is efficacious in relapsed and refractory disease. We conducted a descriptive cost analysis, from the perspective of the Canadian public healthcare system, using trial data.
Methods: The primary outcome was the mean total cost per patient. Resource utilization data were collected from all 75 trial patients over a trial time horizon. Costs are presented in Canadian dollars (2020).
Results: The cost of treatment was calculated from the time of patient (pt) enrollment until the second data lock. The mean total cost was $203 336.08/pt (range $17 891.27-$505 583.55) Canadian dollars (CAD, where 1 CAD = 0.67 Euro (EUR)) and $14 081.45/pt per cycle. The median number of cycles was 15. The predominant cost driver was the cost of chemotherapy accounting for an average of $179 332.78/pt or $12 419.17/pt per cycle. Carfilzomib acquisition accounted for the majority of chemotherapy costs - $162 471.65/pt or $11 251.50/pt per cycle. Fifty-six percent (56%) of patients had at least one hospitalization during the trial period with an average cost of $12 657.86 per hospitalization. Three patients developed thrombotic microangiopathy (TMA) with an average cost of $18 863.32/pt including the cost of hospitalizations and therapeutic plasma exchange.
Conclusions: High-dose wKCD is an active triplet regimen for relapsed and refractory multiple myeloma (RRMM) associated with reduced total cost compared with twice-weekly carfilzomib-based regimens.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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