Medical decision analysis for first-line therapy of chronic myeloid leukemia
| Autor: | Ursula Rochau, Stefan Schmidt, Beate Jahn, Diana I. Brixner, Guenther Gastl, Annette Conrads-Frank, Dominik Wolf, Uwe Siebert, Gaby Sroczynski, Jerald P. Radich, K.R. Saverno |
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| Rok vydání: | 2013 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment Antineoplastic Agents Decision Support Techniques hemic and lymphatic diseases Internal medicine Leukemia Myelogenous Chronic BCR-ABL Positive Antineoplastic Combined Chemotherapy Protocols medicine Humans Computer Simulation Intensive care medicine Protein Kinase Inhibitors Chemotherapy Models Statistical business.industry Hematopoietic Stem Cell Transplantation Myeloid leukemia Disease Management Reproducibility of Results Imatinib Hematology Quality-adjusted life year Dasatinib Treatment Outcome Nilotinib Quality of Life Quality-Adjusted Life Years business Tyrosine kinase medicine.drug Decision analysis |
| Zdroj: | Leukemialymphoma. 55(8) |
| ISSN: | 1029-2403 |
| Popis: | Several tyrosine kinase inhibitors (TKIs) are approved for the treatment of chronic myeloid leukemia (CML). Our goal was to develop a clinical decision-analytic model for evaluation of the long-term effectiveness of different therapy regimens. We developed a Markov cohort model with a lifelong time horizon for first-line treatment with imatinib, dasatinib or nilotinib. Seven strategies including combinations of TKIs, chemotherapy and stem cell transplant were evaluated. The model was parameterized using published trial data, the Austrian CML registry and practice patterns estimated by experts. Health outcomes evaluated were life-years (LYs) and quality-adjusted LYs (QALYs). Based on our decision analysis, dasatinib following nilotinib failure was the most effective treatment in terms of LYs (19.8 LYs) and QALYs (16.1 QALYs). Sensitivity analyses showed that the ranking of strategies was mostly influenced by the duration of first- and second-line therapies. Our results may support decision-making regarding the sequential application of TKIs. |
| Databáze: | OpenAIRE |
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