Abstract:
:The aim of this study was to assess the cost-effectiveness of combination chemotherapy with paclitaxel/cisplatin, compared with standard etoposide/cisplatin in patients with advanced non-small cell lung cancer (NSCLC). We obtained the primary survival and resource utilization data from a large three-arm randomized trial comparing: paclitaxel 135 mg m(-2) by 24-h intravenous (i.v.) infusion + cisplatin; paclitaxel 250 mg m(-2) by 24-h i.v. infusion + cisplatin + granulocyte colony-stimulating factor (G-CSF); and standard etoposide/cisplatin in patients with stage IIIb or IV NSCLC. We also modelled the regimens with paclitaxel 135 mg m(-2) + cisplatin administered as an outpatient by 3-h infusion, as clinical data suggest that this is equivalent to 24-h infusion. We collected costing data from the Ottawa Regional Cancer Centre and applied it to the resources consumed in the randomized trial. We integrated these data into the Statistics Canada POpulation HEalth Model (POHEM), which generated hypothetical cohorts of patients treated with each regimen. The POHEM model assigned diagnostic work-up, treatment, disease progression and survival characteristics to each individual in these cohorts and tabulated the costs associated with each. We did sensitivity analyses around the costs of chemotherapy and its administration, and the survival differences between the two regimens. All costs are in 1997 Canadian dollars ($1.00 Canadian approximately Pound 0.39 sterling). The perspective is that of the Canadian health care system. In the trial, the two paclitaxel-containing arms had almost identical survival curves with a median survival of 9.7 months compared with 7.4 months for etoposide/cisplatin. As administered in the trial, paclitaxel/cisplatin cost $76,370 per life-year gained (LYG) and paclitaxel/cisplatin/G-CSF $138,578 per LYG relative to etoposide/cisplatin. However, when modelled as an outpatient 3-h infusion, paclitaxel/cisplatin was moderately cost-effective at $30,619 per LYG. When compared with historical controls treated with best supportive care, this regimen of paclitaxel/cisplatin cost $4539 per LYG. Assuming a 3-h paclitaxel infusion yields the same survival advantage as the 24-h infusion did in the randomized trial, paclitaxel/cisplatin is a cost-effective improvement over standard etoposide/cisplatin for patients with advanced non-small cell lung cancer.
journal_name
Br J Cancerjournal_title
British journal of cancerauthors
Earle CC,Evans WKdoi
10.1038/sj.bjc.6690426subject
Has Abstractpub_date
1999-05-01 00:00:00pages
815-20issue
5-6eissn
0007-0920issn
1532-1827journal_volume
80pub_type
临床试验,杂志文章,随机对照试验abstract::Studies of families who segregate BRCA2 mutations have found that men who carry disease-associated mutations have an increased risk of prostate cancer, particularly early-onset disease. A study of sporadic prostate cancer in the UK reported a prevalence of 2.3% for protein-truncating BRCA2 mutations among patients dia...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6603929
更新日期:2007-09-17 00:00:00
abstract::Monoclonal antibody MUC 2-63 recognises neurogenic tumours and has been used successfully for radioimaging human malignant gliomas. We now show that the MUC 2-63 antigen has the same tissue distribution and molecular weight range as the CD44 antigen and confirm the identity of these two molecules in blocking studies u...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1994.402
更新日期:1994-11-01 00:00:00
abstract::RNA tumour virus genes are contained in the chromosomal DNA of most vertebrates, and may be transmitted vertically from parent to progeny along with other cellular genes, as well as horizontally as infectious particles. Activation of these viral genes may be part of the means by which RNA tumour viruses produce cancer...
journal_title:British journal of cancer
pub_type: 杂志文章,评审
doi:10.1038/bjc.1978.23
更新日期:1978-02-01 00:00:00
abstract::6-Mercaptopurine (MP)-sensitive and -resistant cell culture lines were used to further characterize the apparent ability of MP nucleotide derivatives to overcome resistance to the parent drug. 6-Mercaptopurine-9-beta-D-ribofuranoside 5'-monophosphate [MPRP], bis(6-mercaptopurine-9-beta-D-ribofuranoside)-5', 5"'-monoph...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1985.73
更新日期:1985-04-01 00:00:00
abstract::Cimetidine has been shown to have beneficial effects in colorectal cancer patients. In this study, a total of 64 colorectal cancer patients who received curative operation were examined for the effects of cimetidine treatment on survival and recurrence. The cimetidine group was given 800 mg day(-1) of cimetidine orall...
journal_title:British journal of cancer
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1038/sj.bjc.6600048
更新日期:2002-01-21 00:00:00
abstract::The degree of lymphocyte infiltration is a prognostic factor in liver cancer, but to date the mechanisms by which lymphocytes infiltrate into and are retained in hepatic tumours are poorly understood. We hypothesised that the extracellular matrix glycoprotein vitronectin, a major component of the stroma of hepatic tum...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6603467
更新日期:2006-12-04 00:00:00
abstract::Fifty patients affected by histologically confirmed gastrointestinal tract cancer (GTC) were treated with oral tegafur (TG) 1,000 mg m-2 p.o. on days 1-14 repeated after a 14 day interval. Out of 42 evaluable patients seven patients had a partial response (PR. 17%) with a median duration of 20.5 weeks, three had a min...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1990.105
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Observational studies suggest greater height is associated with increased ovarian cancer risk, but cannot exclude bias and/or confounding as explanations for this. Mendelian randomisation (MR) can provide evidence which may be less prone to bias. METHODS:We pooled data from 39 Ovarian Cancer Association Con...
journal_title:British journal of cancer
pub_type: 杂志文章,meta分析
doi:10.1038/s41416-018-0011-3
更新日期:2018-04-01 00:00:00
abstract::An enzyme activity with the characteristics of reverse transcriptase was detected in marrow from patients with leukaemia in relapse and in firm haematological remission. The endogenous enzyme activities increased following culture, and in remission patients the enzyme activities reached levels equal to or exceeding th...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1974.95
更新日期:1974-06-01 00:00:00
abstract::Tumour-associated prostaglandin-like material, assessed by bioassay, has been examined in 37 patients with primary and metastatic squamous carcinomas of the head and neck, previously treated by radiotherapy and chemotherapy followed by radical surgery. High amounts of prostaglandin-like material were extracted from tu...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1980.31
更新日期:1980-02-01 00:00:00
abstract::In advanced pancreatic cancer, level one evidence has established a significant survival advantage with chemotherapy, compared to best supportive care. The treatment-associated toxicity needs to be evaluated. This study examines the secondary outcome measures for chemotherapy in advanced pancreatic cancer using meta-a...
journal_title:British journal of cancer
pub_type: 杂志文章,meta分析
doi:10.1038/sj.bjc.6604436
更新日期:2008-07-08 00:00:00
abstract:BACKGROUND:Gestational trophoblastic diseases (GTDs) are related to trophoblasts, and human chorionic gonadotropin (hCG) is secreted by GTDs as well as normal placentas. However, the asparagine-linked sugar chains on hCG contain abnormal biantennary structures in invasive mole and choriocarcinoma, but not normal pregna...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2012.496
更新日期:2012-12-04 00:00:00
abstract:BACKGROUND:Low-dose UCN-01 mediates G1 arrest in normal proliferating cell lines with an intact G1 to S transition but not tumour cells with a deregulated G1 to S checkpoint. Here we hypothesised that UCN-01 is effective in mediating a selective, reversible G1 arrest of normal proliferating cells, resulting in decrease...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/s41416-019-0707-z
更新日期:2020-03-01 00:00:00
abstract::We evaluated the therapeutic usefulness of adjuvant chemotherapy in patients with completely resected non-small cell lung cancer (NSCLC). We also examined the relation between DNA ploidy pattern and the response to chemotherapy. A total of 267 patients with NSCLC (pathologically documented stage I, II, or IIIA) underw...
journal_title:British journal of cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1038/sj.bjc.6603336
更新日期:2006-10-09 00:00:00
abstract::The growth of s.c. Walker 256 carcinoma was found to be independent of secondary growths induced by i.v. injection. Tumour cells injected i.v. lodged mainly in the lungs, with small clusters of cells in the lymph nodes. The rate of cellular proliferation of these secondary growths of Walker carcinoma was significantly...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1978.12
更新日期:1978-01-01 00:00:00
abstract::More women are living with and surviving breast cancer, because of improvements in breast cancer care. Trastuzumab (Herceptin) has significantly improved outcomes for women with HER2-positive tumours. Concerns about the cardiac effects of trastuzumab (which fundamentally differ from the permanent myocyte loss associat...
journal_title:British journal of cancer
pub_type: 杂志文章,实务指引
doi:10.1038/sj.bjc.6604909
更新日期:2009-03-10 00:00:00
abstract::Resistance of tumour cells to methylating and monochloroethylating agents in vitro and in vivo has been linked to levels of the DNA repair protein O6-methylguanine-DNA methyltransferase (MGMT). In a clinical trial of temozolomide in advanced malignant melanoma, the relationship between pretreatment MGMT levels in biop...
journal_title:British journal of cancer
pub_type: 临床试验,杂志文章
doi:10.1038/bjc.1998.654
更新日期:1998-11-01 00:00:00
abstract::Erbicin is a human anti-ErbB2 single-chain antibody fragment with high affinity and selectivity for ErbB2-positive cancer cells. Two anti-ErbB2 immunoconjugates, called Erb-hRNase and Erb-hcAb, have been prepared and found to be selectively cytotoxic on ErbB2-positive cancer cells in vitro and vivo. In Erb-hRNase, Erb...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6604022
更新日期:2007-11-19 00:00:00
abstract::Imaging has an essential role in the planning and delivery of radiotherapy. Recent advances in imaging have led to the development of advanced radiotherapy techniques-including image-guided radiotherapy, intensity-modulated radiotherapy, stereotactic body radiotherapy and proton beam therapy. The optimal use of imagin...
journal_title:British journal of cancer
pub_type: 杂志文章,评审
doi:10.1038/s41416-019-0412-y
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The intestinal uptake of the taxanes paclitaxel and docetaxel is seriously hampered by drug efflux through P-glycoprotein (P-gp) and drug metabolism via cytochrome P450 (CYP) 3A. The resulting low oral bioavailability can be boosted by co-administration of P-gp or CYP3A4 inhibitors. METHODS:Paclitaxel or do...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2014.222
更新日期:2014-05-27 00:00:00
abstract::Pancreatic cancer is characterised by a hallmark desmoplastic response that includes upregulated expression of the extracellular matrix, and type I collagen in particular. Recent studies indicate that pancreatic cancer cells stimulate type I collagen synthesis in adjacent stellate cells, and that this upregulated type...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6603088
更新日期:2006-05-08 00:00:00
abstract::In the present study we have used flow cytometric DNA measurements on synchronised human NHIK 3025 cells to measure cell cycle progression under various conditions of reduced oxygenation. Our data indicate that addition of 0.1 mM deoxycytidine or uridine has no effect on the oxygen-dependent arrest in late G1 or on th...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1994.411
更新日期:1994-11-01 00:00:00
abstract::Carcinoma of the pancreas is an aggressive tumour with an extremely poor prognosis. Recent studies have shown that chemotherapy can improve survival as well as quality of life. Since the prognosis is generally poor, the identification of early responders to chemotherapy is important to avoid unnecessary toxicity in pa...
journal_title:British journal of cancer
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1054/bjoc.2000.1166
更新日期:2000-08-01 00:00:00
abstract::The oncogenicity of Duck hepatitis B virus (DHBV) is unclear since hepatocellular carcinomas (HCCs) have been reported only in domestic ducks in Qidong, an area of China where hepatitis B virus (HBV) and aflatoxin B1 (AFB1) are risk factors for liver cancer in man. In order to better define the association between DHB...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1994.16
更新日期:1994-01-01 00:00:00
abstract::The effect of 6 putative prognostic factors on survival was studied in patients with Stages III and IV malignant teratoma of the testis. Differences between survival curves were tested for statistical significance. A diameter greater than 5 cm in the largest tumour mass, and greater than 8 pulmonary metastases were ad...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1980.332
更新日期:1980-12-01 00:00:00
abstract::Comorbid diseases can affect breast cancer prognosis. We conducted a population-based study of Danish women diagnosed with a first primary breast cancer from 1995 to 2005 (n=9300), using hospital discharge registry data to quantify comorbidities by Charlson score. We examined the influence of comorbidities on survival...
journal_title:British journal of cancer
pub_type: 杂志文章,多中心研究
doi:10.1038/sj.bjc.6603717
更新日期:2007-05-07 00:00:00
abstract:BACKGROUND:Patients with high-grade gliomas are treated with surgery followed by chemoradiation. The risk factors and implications of neurological side effects are not known. METHODS:Acute and late ≥ grade 3 neurological toxicities (NTs) were analysed among 2761 patients from 14 RTOG trials accrued from 1983 to 2003. ...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2011.123
更新日期:2011-04-26 00:00:00
abstract::Ordinary lipomas are cytogenetically characterized by a variety of balanced rearrangements involving chromosome segment 12q13-15, whereas well differentiated liposarcomas (WDL) show supernumerary ring and giant marker chromosomes, known to contain amplified 12q sequences. The tight correlation between the presence of ...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1054/bjoc.1999.1090
更新日期:2000-04-01 00:00:00
abstract::We conducted a national, retrospective population-based cohort study of 705 patients hospitalized with a first diagnosis of dermatomyositis (DM) or polymyositis (PM) during 1982-1996 based on linkage of hospital discharge, cancer registration, and death records in Scotland. Risks of cancer were assessed by calculating...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1054/bjoc.2001.1699
更新日期:2001-07-06 00:00:00
abstract::Deregulated expression of myc proto-oncogenes is implicated in several human neoplasias. We analysed the expression of c-myc, N-myc, L-myc, max and RB1 mRNAs in a panel of human gliomas and glioma cell lines and compared the findings with normal neural cells. The max and RB1 genes were included in the study because th...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1994.3
更新日期:1994-01-01 00:00:00