Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 6/2018

01-06-2018 | Research Article

Cost-effectiveness analysis of sensitive relapsed small-cell lung cancer based on JCOG0605 trial

Authors: K. Zhou, F. Wen, P. Zhang, J. Zhou, H. Zheng, L. Sun, Q. Li

Published in: Clinical and Translational Oncology | Issue 6/2018

Login to get access

Abstract

Purpose

Since combined strategy with cisplatin, etoposide, and irinotecan has shown the superiority to topotecan alone as second-line chemotherapy in patients with sensitive relapsed small-cell lung cancer, this study aimed to compare these two treatments based on JCOG0605 trail from Chinese cost-effectiveness perspective.

Methods

Basic medical information was derived from a multicenter, open-label, randomized phase III trial (JCOG0605). A Markov model including three health states: progression-free state, progressive disease (PD), and death, was developed to simulate the process of sensitive relapsed small-cell lung cancer. Cost was calculated from the perspective of Chinese society. Sensitivity analyses were applied to explore the impact of essential variables.

Results

Treatment with combination chemotherapy was estimated to increase costs by $6947.32 compared with topotecan alone, with a gain of 0.26 quality-adjusted life years (QALYs). Thus, the incremental cost-effective ratio was $26720.46/QALY for combination treatment versus monotherapy, which was beyond the threshold of 3 × the per capita GDP of China, $24423.00. The costs of PD state were the most influential factors to the model.

Conclusion

The combination chemotherapy with cisplatin, etoposide, and irinotecan was not a cost-effectiveness choice for patients with sensitive relapsed SCLC in China from the cost-effectiveness perspective.
Literature
1.
Youlden DR, Cramb SM, Baade PD. The International Epidemiology of Lung Cancer: geographical distribution and secular trends. J Thorac Oncol. 2008;3(8):819–31.CrossRefPubMed
2.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.CrossRefPubMed
3.
Kim YH, Goto K, Yoh K, Niho S, Ohmatsu H, Kubota K, et al. Performance status and sensitivity to first-line chemotherapy are significant prognostic factors in patients with recurrent small cell lung cancer receiving second-line chemotherapy. Cancer. 2008;113:2518–23.CrossRefPubMed
4.
Postmus PE, Berendsen HH, van Zandwijk N, Splinter TA, Burghouts JT, Bakker W. Retreatment with the induction regimen in small cell lung cancer relapsing after an initial response to short term chemotherapy. Eur J Cancer Clin Oncol. 1987;23:1409–11.CrossRefPubMed
5.
Goto K, Ohe Y, Shibata T, Seto T, Takahashi T, Nakagawa K, et al. Combined chemotherapy with cisplatin, etoposide, and irinotecan versus topotecan alone as second-line treatment for patients with sensitive relapsed small-cell lung cancer (JCOG0605): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2016;17(8):1147–57.CrossRefPubMed
6.
O’Brien ME, Ciuleanu TE, Tsekov H, Shparyk Y, Cuceviá B, Juhasz G, et al. Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small-cell lung cancer. J Clin Oncol. 2006;24(34):5441–7.CrossRefPubMed
7.
Von PJ, Schiller JH, Shepherd FA, Fields SZ, Kleisbauer JP, Chrysson NG, et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol. 1999;17(2):658–67.CrossRef
8.
Smit EF, Fokkema E, Biesma B, Groen H, Snoek W, Postmus PEA. Phase II study of paclitaxel in heavily pretreated patients with small-cell lung cancer. Br J Cancer. 1998;77(2):347–51.CrossRefPubMedPubMedCentral
9.
Smyth JF, Smith IE, Sessa C, Schoffski P, Wanders J, Franklin H, et al. Activity of docetaxel (Taxotere) in small cell lung cancer. The Early Clinical Trials Group of the EORTC. Eur J Cancer. 1994;30A(8):1058–60.CrossRefPubMed
10.
Masuda N, Fukuoka M, Kusunoki Y, Matsui K, Takifuji N, Kudoh S, et al. CPT-11: a new derivative of camptothecin for the treatment of refractory or relapsed small-cell lung cancer. J Clin Oncol. 1992;10(8):1225–9.CrossRefPubMed
11.
Masters GA, Declerck L, Blanke C, Sandler A, Devore R, Miller K, et al. Phase II trial of gemcitabine in refractory or relapsed small-cell lung cancer: eastern cooperative oncology group trial 1597. J Clin Oncol. 2003;21(8):1550–5.CrossRefPubMed
12.
Einhorn LH, Pennington K, Mcclean J. Phase II trial of daily oral VP-16 in refractory small cell lung cancer. Semin Oncol. 1990;17(2):32–5.PubMed
13.
Johnson DH, Greco FA, Strupp J, Hande KR, Hainsworth JD. Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer: a phase II trial. J Clin Oncol. 1990;8(10):1613–7.CrossRefPubMed
14.
Chen G, Huynh M, Fehrenbacher L, West H Jr, Yavorkovsky LP, et al. Phase II trial of irinotecan and carboplatin for extensive or relapsed small-cell lung cancer. J Clin Oncol. 2009;27(9):1401–4.CrossRefPubMedPubMedCentral
15.
Naka N, Kawahara M, Okishio K, Hosoe S, Ogawara M, Atagi S, et al. Phase II study of weekly irinotecan and carboplatin for refractory or relapsed small-cell lung cancer. Lung Cancer. 2002;37(3):319–23.CrossRefPubMed
16.
Evans WK, Osoba D, Feld R, Shepherd FA, Bazos MJ, Deboer G. Etoposide (vp-16) and cisplatin: an effective treatment for relapse in small-cell lung cancer. J Clin Oncol. 1985;3(1):65–71.CrossRefPubMed
17.
Figoli F, Veronesi A, Ardizzoni A, Canobbio L, Bruschi G, Mazza F, et al. Cisplatin and etoposide as second-line chemotherapy in patients with small cell lung cancer Cancer Invest. 1988;6(1):1–5.PubMed
18.
Goto K, Sekine I, Nishiwaki Y, Kakinuma R, Kubota K, Matsumoto T, et al. Multi-institutional phase II trial of irinotecan, cisplatin, and etoposide for sensitive relapsed small-cell lung cancer. Br J Cancer. 2004;91(4):659–65.CrossRefPubMedPubMedCentral
19.
Kim Y, Goto K, Nishiwaki Y, Kubota K, Omatsu H, Tamura T, et al. Phase II study of weekly cisplatin, etoposide and irinotecan (PE/CPT) for refractory relapsed small cell lung cancer (SCLC). J Clin Oncol. 2006;24(18):7088–7088.
20.
Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making. 1993;13(4):322–38.CrossRefPubMed
21.
Purmonen T, Martikainen JA, Soini EJ, Kataja V, Vuorinen RL, Kellokumpu-Lehtinen PL. Economic evaluation of sunitinib malate in second-line treatment of metastatic renal cell carcinoma in Finland. Clin Ther. 2008;30:382–92.CrossRefPubMed
22.
23.
24.
Goodwin PJ, Shepherd FA. Economic issues in lung cancer: a review. J Clin Oncol. 2000;16(12):3900–12.CrossRef
25.
Tai TH, Yu E, Dickof P, Beck G, Tonita J, Ago T, et al. Prophylactic cranial irradiation revisited: cost-effectiveness and quality of life in small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2002;52(1):68–74.CrossRefPubMed
26.
Louie AV, Qu MX, Bauman GS, Slotman BJ, Mehta MP, Gondi V, et al. Cost-effectiveness of prophylactic cranial irradiation with hippocampal avoidance in limited stage small cell lung cancer. Int J Radiat Oncol Biol Phys. 2015;93(3):S92.CrossRef
27.
Patrice GI, Patrice SJ, Lester-Coll NH, Yu JB. Exploring the cost-effectiveness of thoracic radiation therapy in extensive-stage small cell lung cancer. Int J Radiat Oncol Biol Phys. 2015;93(3):S92–S92.CrossRef
28.
Oliver E, Killen J, Kiebert G, Hutton J, Hall R, Higgins B, et al. Treatment pathways, resource use and costs in the management of small cell lung cancer. Thorax. 2001;56(10):785–90.CrossRefPubMedPubMedCentral
29.
Groot UD, Mcdonnell J, Velde GT, Radice D, Groen HJM. Cost-effectiveness of hypothetical new cancer drugs in patients with advanced small-cell lung cancer: results of a Markov Chain Model. Ther Clin Risk Manag. 2006;2(3):317–23.CrossRef
30.
Goodwin PJ, Feld R, Evans WK, Pater J. Cost-effectiveness of cancer chemotherapy: an economic evaluation of a randomized trial in small-cell lung cancer. J Clin Oncol. 1988;6(10):1537–47.CrossRefPubMed
31.
Lykopoulos K, Morris S, Papo N, O’Brien ME. PCN71 cost-effectiveness of oral topotecan plus best supportive care versus best supportive care alone in patients with relapsed small-cell lung cancer (SCLC) in the UK. Value Health. 2008;11(6):A482.CrossRef
32.
Inoue A, Sugawara S, Yamazaki K, Maemondo M, Suzuki T, Gomi K, et al. Randomized phase II trial comparing amrubicin with topotecan in patients with previously treated small-cell lung cancer: North Japan Lung Cancer Study Group Trial 0402. J Clin Oncol. 2008;26(33):5401.CrossRefPubMed
33.
Onoda S, Masuda N, Seto T, Eguchi K, Takiguchi Y, Isobe H, Onoda S, et al. Phase II trial of amrubicin for treatment of refractory or relapsed small-cell lung cancer: THORACIC ONCOLOGY RESEARCH Group Study 0301. J Clin Oncol. 2006;24(34):5448.CrossRefPubMed
34.
Jotte R, Conkling P, Reynolds C, Galsky MD, Klein L, Fitzgibbons JF, et al. Randomized phase II trial of single-agent amrubicin or topotecan as second-line treatment in patients with small-cell lung cancer sensitive to first-line platinum-based chemotherapy. J Clin Oncol. 2011;29(3):287–93.CrossRefPubMed
35.
Takeda K, Negoro S, Sawa T, Nakagawa K, Kawahara M, Isobe T, et al. A phase II study of topotecan in patients with relapsed small-cell lung cancer. Clin Lung Cancer. 2003;4(4):224–8.CrossRefPubMed
36.
Eckardt JR, Von Pawel J, Pujol JL, Papai Z, Quoix E, Ardizzoni A, et al. Phase III study of oral compared with intravenous topotecan as second-line therapy in small-cell lung cancer. J Clin Oncol. 2007;25(15):2086–92.CrossRefPubMed
37.
Loveman E, Jones J, Hartwell D, Bird A, Harris P, Welch K, et al. The clinical effectiveness and cost-effectiveness of topotecan for small cell lung cancer: a systematic review and economic evaluation. Health Technol Assess. 2010;14(19):1–204.CrossRef
38.
Messori A, Trippoli S, Tendi E. G-CSF for the prophylaxis of neutropenic fever in patients with small cell lung cancer receiving myelosuppressive antineoplastic chemotherapy: meta-analysis and pharmacoeconomic evaluation. J Clin Pharm Ther. 1996;21(2):57–63.CrossRefPubMed
39.
Chouaid C, Bassinet L, Fuhrman C, Monnet I, Housset B. Routine use of granulocyte colony-stimulating factor is not cost-effective and does not increase patient comfort in the treatment of small-cell lung cancer: an analysis using a Markov model. J Clin Oncol. 1998;16(16):2700–7.CrossRefPubMed
Metadata
Title
Cost-effectiveness analysis of sensitive relapsed small-cell lung cancer based on JCOG0605 trial
Authors
K. Zhou
F. Wen
P. Zhang
J. Zhou
H. Zheng
L. Sun
Q. Li
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 6/2018
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-017-1787-y

Other articles of this Issue 6/2018

Clinical and Translational Oncology 6/2018 Go to the issue

Research Article

Safety of everolimus plus exemestane in patients with hormone-receptor-positive, HER2-negative locally advanced or metastatic breast cancer: results of phase IIIb BALLET trial in Spain

Research Article

Prognostic value of change in anti-thyroglobulin antibodies after thyroidectomy in patients with papillary thyroid carcinoma

Research Article

LOC285629 regulates cell proliferation and motility in colorectal cancer cells

Research Article

MiR-489 suppresses tumor growth and invasion by targeting HDAC7 in colorectal cancer

Special Article

Recommendations for the follow-up care of female breast cancer survivors: a guideline of the Spanish Society of Medical Oncology (SEOM), Spanish Society of General Medicine (SEMERGEN), Spanish Society for Family and Community Medicine (SEMFYC), Spanish Society for General and Family Physicians (SEMG), Spanish Society of Obstetrics and Gynecology (SEGO), Spanish Society of Radiation Oncology (SEOR), Spanish Society of Senology and Breast Pathology (SESPM), and Spanish Society of Cardiology (SEC)

Research Article

No impact of perioperative blood transfusion on prognosis after curative resection for hepatocellular carcinoma: a propensity score matching analysis
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits