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Modified FLOX as first-line chemotherapy for metastatic colorectal cancer patients in the public health system in Brazil: Effectiveness and cost-utility analysis.
Nebuloni, Daniela R; Mak, Milena P; Souza, Fabiano Hahn; Saragiotto, Daniel F; Júlio, Thiago; DE Castro, Gilberto; Sabbaga, Jorge; Hoff, Paulo M.
Afiliação
  • Nebuloni DR; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000; ; Clinical Oncology Department, University of Sao Paulo Medical School, CEP 01246-903;
  • Mak MP; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000; ; Clinical Oncology Department, University of Sao Paulo Medical School, CEP 01246-903;
  • Souza FH; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000; ; Clinical Oncology Department, University of Sao Paulo Medical School, CEP 01246-903;
  • Saragiotto DF; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000; ; Oncology Center, Sírio-Libanês Hospital, CEP 01308-050, Sao Paulo, SP, Brazil.
  • Júlio T; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000;
  • DE Castro G; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000; ; Clinical Oncology Department, University of Sao Paulo Medical School, CEP 01246-903;
  • Sabbaga J; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000;
  • Hoff PM; Clinical Oncology Department, Cancer Institute of the State of Sao Paulo (ICESP), CEP 01246-000;
Mol Clin Oncol ; 1(1): 175-179, 2013 Jan.
Article em En | MEDLINE | ID: mdl-24649143
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/m2 in combination with weekly bolus of 5-fluorouracil (5-FU) (500 mg/m2) for 6 consecutive weeks and oxaliplatin (85 mg/m2) 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation Aspecto: Patient_preference País/Região como assunto: America do sul / Brasil Idioma: En Revista: Mol Clin Oncol Ano de publicação: 2013 Tipo de documento: Article País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation Aspecto: Patient_preference País/Região como assunto: America do sul / Brasil Idioma: En Revista: Mol Clin Oncol Ano de publicação: 2013 Tipo de documento: Article País de publicação: Reino Unido