Genomic signature to guide adjuvant chemotherapy treatment decisions for early breast cancer patients in France: a cost-effectiveness analysis.
| Autor: | Curtit E; University of Franche-Comté, University Hospital of Besançon J. Minjoz, INSERM, EFS UMR 1098, Besançon, France., Bellanger MM; UMR CNRS6051, Ecole des Hautes Etudes en Santé Publique - School of Public Health (EHESP), University of Rennes, Rennes, France., Nerich V; Department of Pharmacy, University Hospital of Besançon, France; INSERM, EFS-BFC, UMR 1098, University of Franche-Comté, Besançon, France., Hequet D; Institut Bourdonnais, Clinique Saint Jean de Dieu, Paris, France., Frenel JS; Institut de Cancérologie de l'Ouest, Saint Herblain, France., Cristeau O; Creativ-Ceutical, Paris, France., Rouzier R; Centre François Baclesse, Caen, France. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in oncology [Front Oncol] 2023 Jun 23; Vol. 13, pp. 1191943. Date of Electronic Publication: 2023 Jun 23 (Print Publication: 2023). |
| DOI: | 10.3389/fonc.2023.1191943 |
| Abstrakt: | Introduction: Chemotherapy (CT) is commonly used as an adjuvant treatment for women with early breast cancer (BC). However, not all patients benefit from CT, while all are exposed to its short- and long-term toxicity. The Oncotype DX ® test assesses cancer-related gene expression to estimate the risk of BC recurrence and predict the benefit of chemotherapy. The aim of this study was to estimate, from the French National Health Insurance (NHI) perspective, the cost-effectiveness of the Oncotype DX ® test compared to standard of care (SoC; involving clinicopathological risk assessment only) among women with early, hormone receptor-positive, human epidermal growth factor receptor 2-negative BC considered at high clinicopathological risk of recurrence. Methods: Clinical outcomes and costs were estimated over a lifetime horizon based on a two-component model that comprised a short-term decision tree representing the adjuvant treatment choice guided by the therapeutic decision support strategy (Oncotype DX ® test or SoC) and a Markov model to capture long-term outcomes. Results: In the base case, the Oncotype DX ® test reduced CT use by 55.2% and resulted in 0.337 incremental quality-adjusted life-years gained and cost savings of €3,412 per patient, compared with SoC. Being more effective and less costly than SoC, Oncotype DX ® testing was the dominant strategy. Discussion: Widespread implementation of Oncotype DX ® testing would improve patient care, provide equitable access to more personalized medicine, and bring cost savings to the health system. Competing Interests: EC, MB, VN, DH, J-SF and RR were paid an honorarium from Creativ-Ceutical for their expertise during this project. ICO received funding from Creativ-Ceutical for the expertise of MB and J-SF on this project. EC also received grants for a translational research project from Novartis SAS and honoraria from Novartis SAS, Exact Sciences, Astra Zeneca, MSD, Cancerodigest, Pfizer, Daiichi Sankyo, and Pierre Fabre outside of this work. J-SF also received consulting fees from Pfizer, Lilly, Novartis, Astra Zeneca, Clovis Oncology, GSK, Gilead, Daiichi Sankyo, Seagen, Exact Sciences, and MSD outside of this work, as well as honoraria from Lilly, Novartis, Astra Zeneca, Gilead, Daiichi Sankyo, Seagen, and MSD outside of this work. DH and RR reported honoraria from Veracyte outside of this work. DH also received grants from Gilead outside of this work. OC was employed by Creativ-Ceutical. Creativ-Ceutical was contracted by Exact Sciences to conduct this study. (Copyright © 2023 Curtit, Bellanger, Nerich, Hequet, Frenel, Cristeau and Rouzier.) |
| Databáze: | MEDLINE |
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