Costs of treatment and outcomes associated with second-line therapy and greater for relapsed ovarian cancer Journal Article
| Authors: | Prasad, M.; Ben-Porat, L.; Hoppe, B.; Aghajanian, C.; Sabbatini, P.; Chi, D. S.; Hensley, M. L. |
| Article Title: | Costs of treatment and outcomes associated with second-line therapy and greater for relapsed ovarian cancer |
| Abstract: | Objective. Most women with epithelial ovarian cancer (EOC) will develop disease progression or recurrence with resistance to platinum therapy. We report overall costs and treatment outcomes associated with topotecan or gemcitabine administration in platinum- and paclitaxel-resistant EOC patients. Methods. Patients who received topotecan (n = 51) or gemcitabine (n = 56) as second-line therapy or greater for platinum- and paclitaxel-resistant EOC were retrospectively identified. Per patient costs for each regimen were determined and compared. Results. The mean total direct cost per cycle per patient of gemcitabine was $2732.28, with a median total direct cost per cycle of $1382.73. The mean total direct cost per cycle per patient of topotecan was $7832.07, with a median total direct cost per cycle of $4219.02. By comparison of the means, total direct cost per cycle per patient was significantly more expensive for topotecan (P = 0.001). Fifty-six patients received a total of 415 cycles of gemcitabine, median 5 cycles per patient (range, 1-59). Thirteen (23.2%; 95% CI, 11.9-34.5%) of 56 patients displayed clinical benefit, with median PFS of 1.8 months and median overall survival (OS) of 8.2 months. Fifty-one patients received topotecan, for a total of 264 cycles, median 4 cycles per patient (range, 1-42). Twenty-eight (56%; 95% CI, 42.0-70.0%) of 50 patients achieved clinical benefit, with PFS and OS medians of 3.6 and 16.8 months, respectively. Conclusion. Gemcitabine and topotecan are active agents in heavily pretreated, platinum- and paclitaxel-resistant EOC patients. Topotecan was more costly to deliver. Although a larger percentage of patients received clinical benefit with topotecan use, this likely reflects physician selection for use of topotecan earlier in the course of disease. © 2004 Published by Elsevier Inc. |
| Keywords: | adolescent; adult; controlled study; treatment outcome; aged; middle aged; major clinical study; disease course; neutropenia; cancer recurrence; salvage therapy; cisplatin; doxorubicin; cancer growth; gemcitabine; paclitaxel; comparative study; topotecan; ovarian cancer; ovarian neoplasms; carboplatin; ovary cancer; neoplasm recurrence, local; erythropoietin; anemia; bone marrow suppression; drug resistance, neoplasm; drug costs; statistical significance; recurrent disease; platinum; health care costs; deoxycytidine; organoplatinum compounds; granulocyte colony stimulating factor; cost of illness; cost benefit analysis; second-line therapy; humans; human; female; priority journal; article |
| Journal Title: | Gynecologic Oncology |
| Volume: | 93 |
| Issue: | 1 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2004-04-01 |
| Start Page: | 223 |
| End Page: | 228 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2004.01.014 |
| PROVIDER: | scopus |
| PUBMED: | 15047240 |
| DOI/URL: | |
| Notes: | Gynecol. Oncol. -- Cited By (since 1996):4 -- Export Date: 16 June 2014 -- CODEN: GYNOA -- Source: Scopus |
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