Cost Effectiveness of Adjuvant Interferon in Node-Positive Melanoma

Cormier, Janice N.; Xing, Yan; Ding, Meichun; Cantor, Scott B.; Salter, Kristi J.; Lee, Jeffrey E.; Mansfield, Paul F.; Gershenwald, Jeffrey E.; Ross, Merrick I.

doi:10.1200/jco.2007.10.7284

Cited by 24 publications

(29 citation statements)

References 35 publications

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“…Of the resulting 22 articles, 3 were excluded due to lack of relevance (1 was a review of original articles already included [31], 2 were comparisons of surgical options rather than pharmacologic therapies [32,33]), 1 was an abstract corresponding to a full-text article already included [34] and 3 were excluded for lack of sufficiently reported detail [30,35,36]. The resulting 15 articles were included in the review: seven described therapies for resectable melanoma [27,[37][38][39][40][41][42], while the remaining eight described therapies for unresectable or metastatic melanoma [19,26,28,29,[43][44][45].…”

Section: Resultsmentioning

confidence: 99%

Cost–effectiveness of therapies for melanoma

Johnston¹,

McPherson

Osenenko³

et al. 2015

Expert Review of Pharmacoeconomics & Outcomes Research

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Melanoma presents an important burden worldwide. Until recently, the prognosis for unresectable and metastatic melanoma was poor, with 10% of metastatic melanoma patients surviving for 2 years. The introduction of newer therapies including ipilimumab, vemurafenib, dabrafenib and trametinib improved progression-free survival, with additional benefits anticipated from the forthcoming class of programmed cell death 1 inhibitors. Cost of therapy and resulting cost-effectiveness is an important factor in determining patient access to specific treatments. The objective of this study was to review the published evidence regarding cost-effectiveness of melanoma therapies and provide an overview of the relative cost-effectiveness of available therapies by disease stage. For earlier-stage disease, IFN-α has been found to be cost-effective, although its clinical benefits have not been well established. For unresectable and metastatic melanoma, newer therapies provide benefits over standard-of-care chemotherapy, but comprehensive analyses will need to be conducted to determine the most cost-effective therapy.

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Section: Resultsmentioning

confidence: 99%

Cost–effectiveness of therapies for melanoma

Johnston¹,

McPherson

Osenenko³

et al. 2015

Expert Review of Pharmacoeconomics & Outcomes Research

View full text Add to dashboard Cite

show abstract

“…Anderson Cancer Center (Houston, TX) showed that interferon use is not cost-effective in micronodal disease (ie, those patients identified by SNB). 13 The few months of additional disease-free survival afforded patients treated by interferon is outweighed by the severe toxicity of this therapy. The ''nail in the coffin'' with regard to interferon use in SNB-positive patients, however, came with the long-awaited completion of the Sunbelt Melanoma Trial.…”

Section: Is Snb a Staging And/or Therapeutic Procedure?mentioning

confidence: 99%

Sentinel node biopsy and standard of care for melanoma: A re-evaluation of the evidence

Kanzler¹

2010

Journal of the American Academy of Dermatology

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“…This is illustrated in the most recent analysis performed by Cormier et al who quote a cost-effectiveness ranging from US$76,000 to US$169,000 per QALY (depending on disease stage), crossing the historic threshold of US$100,000 per QALY as the cost-effective limit. 16 There are no studies available addressing these same questions for pegIFNa-2b in the adjuvant setting for highrisk resected melanoma. Perhaps a preliminary assumption might be that this is unlikely to be favorable, given that the EORTC 18991 study did not show an OS benefit with treatment, and the health-related quality of life impact associated with treatment was clearly detrimental.…”

Section: Economic Impactmentioning

confidence: 99%

“…Such analysis has been carried out for the US, Canada, UK, and Spain. [16][17][18] In general, the cost-effectiveness ratios postulated range between US$20,000 and US$50,000 per life year gained. There seems to be a larger cost-effective margin for younger patients in more advanced stages of disease.…”

Section: Economic Impactmentioning

confidence: 99%

Pegylated interferon alpha-2b as adjuvant treatment of Stage III malignant melanoma: an evidence-based review

Okuyama¹,

González²,

Lewis³

2010

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Introduction:Stage III melanoma, also referred to as regional metastatic melanoma, has five-year survival rates ranging between 40% and 78%. In order to reduce the likelihood of recurrence in this high-risk population, patients undergo resection of primary tumors and all involved nodal basins. Systemic therapy is being pursued in an effort to improve outcome data, but the best strategy has yet to be defined. Interferon alpha-2b remains to date the most promising approach available. Toxicities and intensive intravenous administration, unfortunately, are major concerns. An alternative is the use of interferon in its pegylated subcutaneous form. The aim of this research was to review the evidence for the use of pegylated interferon alpha-2b in Stage III malignant melanoma. Evidence review: ECOG 1684 was the pivotal trial that first demonstrated a statistically significant benefit in relapse-free and overall survival for adjuvant interferon alpha-2b in high-risk melanoma. Other larger studies, such as ECOG 1690, confirmed a relapse-free survival benefit but did not achieve statistical significance for overall survival. The first study of the pegylated form of interferon alpha-2b in Stage III melanoma, EORTC 18991, is reviewed here. This trial showed a statistically significant improvement in relapse-free survival but not overall survival. Encouraging data of potential equivalent efficacy, easier administration, and fewer Grade 3 and 4 adverse reactions compared with high-dose intravenous interferon raises the question of its potential role in Stage III melanoma in the adjuvant setting. Keywords: pegylated interferon alpha-2b, melanoma, peg-interferon, adjuvant

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Cost Effectiveness of Adjuvant Interferon in Node-Positive Melanoma

Abstract: Our model demonstrates that the probability of HDI being cost effective varies substantially by melanoma substage. HDI showed the greatest benefit in terms of QALYs and was most cost effective in patients younger than 60 years with stage IIIC disease.

Cited by 24 publications

References 35 publications

Cost–effectiveness of therapies for melanoma

Cost–effectiveness of therapies for melanoma

Sentinel node biopsy and standard of care for melanoma: A re-evaluation of the evidence

Pegylated interferon alpha-2b as adjuvant treatment of Stage III malignant melanoma: an evidence-based review

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