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Costs of treatment and outcomes associated with second-line therapy and greater for relapsed ovarian cancer.

Abstract：

OBJECTIVES:Most women with epithelial ovarian cancer (EOC) will develop disease progression or recurrence with resistance to platinum therapy. We report overall costs and treatment outcomes associated with topotecan or gemcitabine administration in platinum- and paclitaxel-resistant EOC patients. METHODS:Patients who received topotecan (n = 51) or gemcitabine (n = 56) as second-line therapy or greater for platinum- and paclitaxel-resistant EOC were retrospectively identified. Per patient costs for each regimen were determined and compared. RESULTS:The mean total direct cost per cycle per patient of gemcitabine was $2732.28, with a median total direct cost per cycle of $1382.73. The mean total direct cost per cycle per patient of topotecan was $7832.07, with a median total direct cost per cycle of $4219.02. By comparison of the means, total direct cost per cycle per patient was significantly more expensive for topotecan (P = 0.001). Fifty-six patients received a total of 415 cycles of gemcitabine, median 5 cycles per patient (range, 1-59). Thirteen (23.2%; 95% CI, 11.9-34.5%) of 56 patients displayed clinical benefit, with median PFS of 1.8 months and median overall survival (OS) of 8.2 months. Fifty-one patients received topotecan, for a total of 264 cycles, median 4 cycles per patient (range, 1-42). Twenty-eight (56%; 95% CI, 42.0-70.0%) of 50 patients achieved clinical benefit, with PFS and OS medians of 3.6 and 16.8 months, respectively. CONCLUSIONS:Gemcitabine and topotecan are active agents in heavily pretreated, platinum- and paclitaxel-resistant EOC patients. Topotecan was more costly to deliver. Although a larger percentage of patients received clinical benefit with topotecan use, this likely reflects physician selection for use of topotecan earlier in the course of disease.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Prasad M,Ben-Porat L,Hoppe B,Aghajanian C,Sabbatini P,Chi DS,Hensley ML

doi

10.1016/j.ygyno.2004.01.014

subject

Has Abstract

pub_date

2004-04-01 00:00:00

pages

223-8

issue

eissn

0090-8258

issn

1095-6859

pii

S0090825804000319

journal_volume

pub_type

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Costs of treatment and outcomes associated with second-line therapy and greater for relapsed ovarian cancer.