Trastuzumab in early stage breast cancer: A cost-effectiveness analysis for Belgium

Neyt, Mattias; Huybrechts, Michel; Hulstaert, Frank; Vrijens, F.; Ramaekers, Dirk

doi:10.1016/j.healthpol.2007.11.003

Cited by 49 publications

(55 citation statements)

References 14 publications

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“…Trastuzumab in particular has been used successfully to treat to HER2-positive, early and metastatic breast cancer [128][129][130]. When used in combination with conventional chemotherapeutic drugs, trastuzumab results in a response rate of between 50 and 84% [129,[131][132][133].…”

Section: Clinical Relevance Of Breast Cancer Stem Cell Theory and Impmentioning

confidence: 99%

Cancer stem cells in breast cancer and metastasis

Lawson

Blatch

Edkins

2009

Breast Cancer Res Treat

109

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The cancer stem cell theory poses that cancers develop from a subset of malignant cells that possess stem cell characteristics and has been proposed to account for the development of a variety of malignancies, including breast cancer. These cancer stem cells (CSC) possess characteristics of both stem cells and cancer cells, in that they have the properties of self-renewal, asymmetric cell division, resistance to apoptosis, independent growth, tumourigenicity and metastatic potential. A CSC origin for breast cancer can neatly explain both the heterogeneity of breast cancers and the relapse of the tumours after treatment. However, many reports on CSC in the breast are contradictory. There is variation with respect to how breast cancer stem cells should be identified, their characteristics and a possible lack of correlation between clinical outcome and breast cancer stem cell status of a tumour. These combined factors have made breast cancer stem cells a highly contentious issue. In this review, we highlight the progress in the analysis of cancer stem cells, with an emphasis on breast cancer.

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Section: Clinical Relevance Of Breast Cancer Stem Cell Theory and Impmentioning

confidence: 99%

Cancer stem cells in breast cancer and metastasis

Lawson

Blatch

Edkins

2009

Breast Cancer Res Treat

109

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“…For example, some analysis suggest that a 9-week Trastuzumab regimen could result in cost savings compared with 52-week therapy [44,53] but this warrants further investigation as the claim in based on a review of other reviews rather than a trial designed to explore this issue. With respect to age, Chan et al concluded that as an adjuvant therapy, Trastuzumab was cost-effective in women aged below 65 over a life-time horizon, but not cost-effective in patients aged over 75 or with a time horizon of less than 10 years [33].…”

Section: Duration Of Use Time Horizon and Agementioning

confidence: 99%

“…How models are populated also varies though the relatively small number of trials relating to use of Trastuzumab in early stage breast cancer has served to limit heterogeneity here. Data from the HERceptin Adjuvant (HERA) [53,54,65,66] trial has become the most commonly used source for evaluations of treatment in an early stage setting. Differences regarding DFS rates (disease-free state), duration of treatment effect, disease recurrence, cardiac toxicity, mortality, transition probability between trials will lead to significant differences in model parameters and choices in which outcomes to focus on can influence estimated ICERs even when these are derived from the same trial.…”

Section: Modellingmentioning

confidence: 99%

A Critical Review of Economic Evaluations of Trastuzumab in the Treatment of Early Stage HER2 Positive Breast Cancer

Nguyen¹,

Nguyen²,

O'Neill³

2017

Pharmacoeconomics

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Eleven years after Trastuzumab was approved for use in the treatment of early stage human epidermal growth factor receptor positive breast cancer (HER2+) its clinical benefit has been demonstrated in short and long term follow up studies. The cost-effectiveness of the therapy in this context remains the subject of debate with a wide range of Incremental Cost Effectiveness Ratios (ICERs) reported in the literature. While several reviews of the literature have been undertaken these have not provided a critical analysis of the factors that might underlie this heterogeneity. In this review we provide a critical overview of the literature and discuss potential sources of heterogeneity in reported ICERs. We identify gaps in the current literature and provide a rationale for filling these gaps.

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“…A total of 11 publications met the inclusion criteria [37][38][39][40][41][42][43][44][45][46][47]. All studies used decision-analytic modeling.…”

Section: Economic Evaluations Of Trastuzumab In Early Breast Cancermentioning

confidence: 99%

“…Two studies combined data from different trastuzumab regimens into one intervention that was compared to care as usual [42,44]. More than one trastuzumab regimen was considered by four studies [37,40,42,43]. In these studies the different trastuzumab regimens were all compared to care as usual, which means that they did not calculate the cost-effectiveness of one strategy to the next best strategy.…”

Section: Economic Evaluations Of Trastuzumab In Early Breast Cancermentioning

confidence: 99%

Bridging Trial and Decision: A Checklist to Frame Health Technology Assessments for Resource Allocation Decisions

et al. 2011

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We developed a comprehensive checklist with 11 factors to frame HTAs and to assess the applicability of HTAs to resource allocation decisions. Economic evaluations on trastuzumab considered some of these factors, but overlooked others. The proposed checklist assists in systematically considering all factors in developing the conceptual model of an HTA, to make HTAs better reflect the decision problem.

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Trastuzumab in early stage breast cancer: A cost-effectiveness analysis for Belgium

Cited by 49 publications

References 14 publications

Cancer stem cells in breast cancer and metastasis

Cancer stem cells in breast cancer and metastasis

A Critical Review of Economic Evaluations of Trastuzumab in the Treatment of Early Stage HER2 Positive Breast Cancer

Bridging Trial and Decision: A Checklist to Frame Health Technology Assessments for Resource Allocation Decisions

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