Modified FLOX as first-line chemotherapy for metastatic colorectal cancer patients in the public health system in Brazil: Effectiveness and cost-utility analysis

Autor:	Jorge Sabbaga, Daniel Fernandes Saragiotto, Fabiano Hahn Souza, Paulo M. Hoff, Daniela R. Nebuloni, Milena Perez Mak, Gilberto de Castro, Thiago Júlio
Rok vydání:	2012
Předmět:	Oncology Cancer Research medicine.medical_specialty Cost–utility analysis business.industry Colorectal cancer Public health Cancer Articles medicine.disease Oxaliplatin Surgery Regimen Internal medicine medicine Bolus (digestion) First line chemotherapy business medicine.drug
Zdroj:	Molecular and Clinical Oncology. 1:175-179
ISSN:	2049-9469 2049-9450
DOI:	10.3892/mco.2012.12
Popis:	Incorporation of new drugs for treatment of metastatic colorectal cancer (mCRC) has led to a clear improvement in overall patient survival, the added cost of treatment, however, is a major concern worldwide. The cost-effectiveness of using a modified FLOX (mFLOX) regimen for treating mCRC patients was delineated. In this study, 82 consecutive mCRC patients were treated with leucovorin (LV) at 20 mg/m 2 in combination with weekly bolus of 5-fluorouracil (5-FU) (500 mg/m 2 ) for 6 consecutive weeks and oxaliplatin (85 mg/m 2 ) at weeks 1, 3 and 5, every 8 weeks. Overall survival (OS) and toxicity were evaluated. A Markov Model with a 2-year time horizon and 2-week cycles was developed, comparing mFLOX and mFOLFOX6 in a Brazilian environment. Health outcomes were measured in quality-ajusted life years (QALYs). The median overall period of survival was 19 months, while the estimated 1-year survival was 75%. Response by RECIST was assessed in 33 patients. Partial response was observed in 39.4% of patients, while 36.3% were stable. The mFLOX regimen cost was BRL 9,000, while the mFOLFOX6 BRL 22,000 (1 EUR=2.29 BRL), leading to an incremental costed of BRL 13,000, considering a 20-week period of first -line therapy. The incremental effect of the mFOLFOX was of 0,117 QALY. The incremental cost- effectiveness ratio of mFOLFOX6 was of BRL 110,344/QALY. The sensitivity analysis detected no differences in the outcome measures. In conclusion, the mFLOX is an active regimen in mCRC patients, possibly providing a cost-effective option in public health systems.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::25e80e0a6c8e5b2a6ec6a4ff75d6e1d9 https://doi.org/10.3892/mco.2012.12 Zobrazit plný text záznamu