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BMC Cancer. 2012 Jul 20;12:301. doi: 10.1186/1471-2407-12-301.

Cost effectivenes of erlotinib versus chemotherapy for first-line treatment of non small cell lung cancer (NSCLC) in fit elderly patients participating in a prospective phase 2 study (GFPC 0504).

Author information

  • 1AP-HP Hôpital St-Antoine, AP-HP, UMPC, Paris, France. Christos.chouaid@sat.aphp.fr

Abstract

BACKGROUND:

The median age of newly diagnosed patients with non-small cell lung cancer (NSCLC) is 67 years, and one-third of patients are older than 75 years. Elderly patients are more vulnerable to the adverse effects of chemotherapy, and targeted therapy might thus be a relevant alternative. The objective of this study was to assess the cost-effectiveness of erlotinib followed by chemotherapy after progression, compared to the reverse strategy, in fit elderly patients with advanced NSCLC participating in a prospective randomized phase 2 trial (GFPC0504).

METHODS:

Outcomes (PFS and overall survival) and costs (limited to direct medical costs, from the third-party payer perspective) were prospectively collected until second progression. Costs after progression and health utilities (based on disease states and grade 3-4 toxicities) were derived from the literature.

RESULTS:

Median overall survival, QALY and total costs for the erlotinib-first strategy were respectively 7.1 months, 0.51 and 27 734 €, compared to 9.4 months, 0.52 and 31 688 € for the chemotherapy-first strategy. The Monte Carlo simulation demonstrates that the two strategies do not differ statistically.

CONCLUSION:

In terms of cost effectiveness, in fit elderly patients with NSCLC, erlotinib followed by chemotherapy compares well with the reverse strategy.

PMID:
22817667
PMCID:
PMC3492214
DOI:
10.1186/1471-2407-12-301
[PubMed - indexed for MEDLINE]
Free PMC Article
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