Trastuzumab with carboplatin/paclitaxel for treatment of advanced stage and recurrent uterine papillary serous carcinoma: A cost-effectiveness analysis.


OBJECTIVE:Uterine papillary serous carcinoma (UPSC) is a variant of endometrial cancer that is aggressive and associated with poor outcomes. We sought to evaluate the cost effectiveness of carboplatin/paclitaxel alone versus carboplatin/paclitaxel with trastuzumab among patients with Her2/neu-positive advanced or recurrent UPSC. METHODS:We designed a Markov model in TreeAge Pro 2019 software to simulate management of a theoretical cohort of 4000 patients with Her2/neu-positive advanced or recurrent uterine papillary serous carcinoma (UPSC) followed for four years. In the carboplatin/paclitaxel with trastuzumab strategy, we included the cost of testing for Her2/neu status. We obtained all model inputs from the literature and a societal perspective was assumed. Outcomes included progression-free survival, progression, UPSC-specific mortality, cost, and quality-adjusted life years (QALYs). The intervention was considered cost effective if the incremental cost-effectiveness ratio (ICER) was below the willingness-to-pay threshold of $100,000 per QALY. Sensitivity analyses were used to determine the robustness of the results. RESULTS:In our theoretical cohort of 4000 women, treatment with the addition of trastuzumab resulted in 637 fewer deaths and 627 fewer cases of progression compared with treatment with carboplatin/paclitaxel alone. Treatment with trastuzumab was associated with an additional cost of $144,335,895, but was associated with an increase of 2065 QALYs. The ICER was $69,903 per QALY, which was below our willingness-to-pay threshold. Sensitivity analysis demonstrated that this treatment strategy was cost-effective until the cost of 6 months of treatment surpassed $38,505 (baseline input: $27,562). CONCLUSION:We found that the addition of trastuzumab to carboplatin/paclitaxel was a cost-effective treatment strategy for patients with advanced/recurrent Her2/neu-positive UPSC.


Gynecol Oncol


Gynecologic oncology


Batman S,Bohn J,Weisenberger MW,Hersh A,Bruegl A,Caughey A,Winter W 3rd




Has Abstract


2021-01-01 00:00:00














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    abstract::Thirty-eight patients with advanced or recurrent carcinoma of the endometrium who had received no prior chemotherapy were placed on study by the Gynecologic Oncology Group. One was deemed histologically ineligible. Three patients had insufficient trials to evaluate response. Of the remaining 34 who received hexamethyl...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Thigpen JT,Blessing JA,Ball H,Hanjani P,Manetta A,Homesley H

    更新日期:1988-11-01 00:00:00

  • Current techniques in screening for cervical cancer in Spain: updated recommendations.

    abstract::A population-based survey (AFRODITA Study) was conducted in Spain in order to estimate the coverage and factors associated with cervical cancer cytological screening. The results of this survey indicate that the rate of screening for cervical cancer in Spain is 75.6% in women between 18 and 65 years. This high rate of...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Puig-Tintoré LM,Torné A,Alonso I

    更新日期:2008-09-01 00:00:00

  • Management of malignant, mixed mesodermal tumors of the uterus.

    abstract::Forty-two patients with malignant, mixed mesodermal tumors of the uterus were identified by retrospective chart review. Only 2 patients were premenopausal at the time of diagnosis. Six of the patients had previously received pelvic radiotherapy. Surgical/pathologic findings were inconsistent with clinical staging in 1...

    journal_title:Gynecologic oncology

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    authors: Podczaski ES,Woomert CA,Stevens CW Jr,Manetta A,Larson JE,Zaino RJ,Mortel R

    更新日期:1989-02-01 00:00:00

  • Human immunodeficiency virus infection and invasive cervical cancer in South Africa.

    abstract:PURPOSE:The goal of this study was to determine whether South African HIV-seropositive women with invasive cervical cancer present with disease that is more advanced than that of HIV-seronegative women and whether degree of immunosuppression affects the extent of disease at initial presentation. METHODS:This study is ...

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    pub_type: 杂志文章


    authors: Lomalisa P,Smith T,Guidozzi F

    更新日期:2000-06-01 00:00:00

  • Trimetrexate in the treatment of recurrent or advanced leiomyosarcoma of the uterus: a phase II study of the Gynecologic Oncology Group.

    abstract:OBJECTIVE:This study was conducted to determine the objective response of trimetrexate in patients with advanced or recurrent leiomyosarcoma of the uterus. METHODS:Eligibility was restricted to patients with measurable disease who had received no more than one prior chemotherapy regimen, who had adequate bone marrow, ...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Smith HO,Blessing JA,Vaccarello L

    更新日期:2002-01-01 00:00:00

  • Decreased expression of the CDK inhibitor p27Kip1 and increased oxidative DNA damage in the multistep process of cervical carcinogenesis.

    abstract:OBJECTIVE:The expression of the CDK inhibitor p27Kip1 and the extent of endogenous oxidative DNA damage were evaluated in the multistep cervical carcinogenesis. METHODS:Archival specimens of low-grade (L) squamous intraepithelial lesions (SILs) (n=32), high-grade (H) SILs (n=24) and invasive carcinomas (n=48) of the c...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Sgambato A,Zannoni GF,Faraglia B,Camerini A,Tarquini E,Spada D,Cittadini A

    更新日期:2004-03-01 00:00:00

  • Does methotrexate (MTX) dosing in a 8-day MTX/FA regimen for the treatment of low-risk gestational trophoblastic neoplasia affect outcomes? The MITO-9 study.

    abstract:OBJECTIVE:To compare clinical outcomes of patients diagnosed with low-risk gestational trophoblastic neoplasia (GTN) receiving intramuscular methotrexate 50 mg total dose/day versus 1 mg/kg/day in a 8-day methotrexate/folinic acid (MTX/FA) regimen. METHODS:This retrospective, multicenter study included 176 patients: 9...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,多中心研究


    authors: Mangili G,Cioffi R,Danese S,Frigerio L,Ferrandina G,Cormio G,Rabaiotti E,Scarfone G,Gadducci A,Bergamini A,Pisano C,Candiani M

    更新日期:2018-12-01 00:00:00

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    pub_type: 杂志文章


    authors: Tiller K,Meiser B,Butow P,Clifton M,Thewes B,Friedlander M,Tucker K

    更新日期:2002-08-01 00:00:00

  • Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: Are two therapies better than one?

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    journal_title:Gynecologic oncology

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    authors: Moore DH

    更新日期:2009-06-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Buckingham L,Haggerty A,Graul A,Morgan M,Burger R,Ko E,Andy U,Giuntoli R

    更新日期:2019-01-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Mutter GL,Baak JP,Fitzgerald JT,Gray R,Neuberg D,Kust GA,Gentleman R,Gullans SR,Wei LJ,Wilcox M

    更新日期:2001-11-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Gotlieb WH,Bruchim I,Gu J,Shi Y,Camirand A,Blouin MJ,Zhao Y,Pollak MN

    更新日期:2006-02-01 00:00:00

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    pub_type: 杂志文章


    authors: Ghosh K,Downs LS,Padilla LA,Murray KP,Twiggs LB,Letourneau CM,Carson LF

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    pub_type: 杂志文章


    authors: Rubin SC,Hoskins WJ,Lewis JL Jr

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    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Hynninen J,Auranen A,Carpén O,Dean K,Seppänen M,Kemppainen J,Lavonius M,Lisinen I,Virtanen J,Grénman S

    更新日期:2012-07-01 00:00:00

  • Specialist surgery for ovarian cancer in England.

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    authors: Butler J,Gildea C,Poole J,Meechan D,Nordin A

    更新日期:2015-09-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: Cadron I,Van Gorp T,Timmerman D,Amant F,Waelkens E,Vergote I

    更新日期:2009-12-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Rudoff J,Percy R,Benrubi G,Ostrowski ML

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    authors: Jumean HG,Komorowski R,Mahvi D,Anderson T

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    authors: Longatto Filho A,Pereira SM,Di Loreto C,Utagawa ML,Makabe S,Sakamoto Maeda MY,Marques JA,Santoro CL,Castelo A

    更新日期:2005-05-01 00:00:00

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    pub_type: 杂志文章


    authors: Beeghly A,Katsaros D,Chen H,Fracchioli S,Zhang Y,Massobrio M,Risch H,Jones B,Yu H

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    pub_type: 杂志文章


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    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: Cao Y,Abbas J,Wu X,Dooley J,van Amburg AL

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    pub_type: 杂志文章


    authors: Baba T,Kariya M,Higuchi T,Mandai M,Matsumura N,Kondoh E,Miyanishi M,Fukuhara K,Takakura K,Fujii S

    更新日期:2007-06-01 00:00:00

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    pub_type: 杂志文章


    authors: Stegeman M,Louwen M,van der Velden J,ten Kate FJ,den Bakker MA,Burger CW,Ansink AC

    更新日期:2007-05-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Vecek N,Nola M,Marusić M,Babić D,Uzarević B,Sabioncello A,Petrovecki M,Ljubić-Racunica N,Marinović T

    更新日期:1994-04-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Elliott KS,Borowsky ME,Lee YC,Rao C,Abulafia O

    更新日期:2004-10-01 00:00:00

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    journal_title:Gynecologic oncology

    pub_type: 杂志文章,meta分析


    authors: Pan QJ,Hu SY,Guo HQ,Zhang WH,Zhang X,Chen W,Cao J,Jiang Y,Zhao FH,Qiao YL

    更新日期:2014-05-01 00:00:00

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    pub_type: 杂志文章,评审


    authors: Lee L,Matulonis U

    更新日期:2019-07-01 00:00:00