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Article

Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences

  • Authors:
    • Daniel Ruiz‑Sánchez
    • Irene Iglesias Peinado
    • Miguel Alaguero‑Calero
    • Alejandro José Sastre‑Heres
    • Benito García Diez
    • Jaime Peña‑Díaz
  • View Affiliations / Copyright

    Affiliations: Department of Pharmacy, Central Universitary Hospital of Asturias, 33011 Oviedo, Asturias, Spain, School of Pharmacy, The Complutense University of Madrid, 28040 Madrid, Spain, Department of Pharmacy, San Juan de Dios Hospital, 50006 Zaragoza, Spain, Department of Pharmacy, Severo Ochoa University Hospital, Leganés, 28911 Madrid, Spain, School of Pharmacy, University of Granada, 18011 Granada, Spain
  • Pages: 1935-1940
    |
    Published online on: July 15, 2016
       https://doi.org/10.3892/ol.2016.4871
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Abstract

The purpose of the present study was to calculate the cost-effectiveness of the inclusion of the bevacizumab (BVZ) + irinotecan (CPT-11) regimen in the second‑line of treatment for primary glioblastoma multiforme. A retrospective cohort study with a control group was performed in which the cost‑effectiveness of a course of chemotherapy was calculated based on survival time and the incremental cost between the two lines of treatment. A total of 77 patients were included, 36 of who formed the BVZ/CPT‑11 cohort. The median survival time for the non‑BVZ control cohort was 13.23 months [95% confidence interval (CI), 11.79‑14.68], while for the BVZ/CPT‑11 treatment cohort, the median survival time was 17.63 months (95% CI, 15.38‑19.89). Overall, each year of life gained for each patient treated with BVZ/CPT‑11 would cost €46,401.99. These results demonstrate the effectiveness of the BVZ/CPT-11 combination, but its incremental cost compared with other lines of treatment or the best care available does not appear to be acceptable for public health systems in the current situation of budgetary adjustments.
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1 

Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, Wolinsky Y, Kruchko C and Barnholtz-Sloan J: CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2007–2011. Neuro Oncol. 16(Suppl 4): iv1–iv63. 2014. View Article : Google Scholar : PubMed/NCBI

2 

Gurney JG and Kadan-Lottick N: Brain and other central nervous system tumors: Rates, trends and epidemiology. Curr Opin Oncol. 13:160–166. 2001. View Article : Google Scholar : PubMed/NCBI

3 

Fuentes-Raspall R, Vilardell L, Perez-Bueno F, Joly C, Garcia-Gil M, Garcia-Velasco A and Marcos-Gragera R: Population-based incidence and survival of central nervous system (CNS) malignancies in Girona (Spain) 1994–2005. J Neurooncol. 101:117–123. 2011. View Article : Google Scholar : PubMed/NCBI

4 

Tumours register of the health service of the principality of Asturias for 2013. ISSN: 2176-6885. http://www.hca.es/huca/web/main.asp?id_pagina=29Accessed. June 25–2015

5 

Brem SS, Bierman PJ, Brem H, Butowski N, Chamberlain MC, Chiocca EA, DeAngelis LM, Fenstermaker RA, Friedman A, Gilbert MR, et al: Central nervous system cancers. J Natl Compr Canc Netw. 9:352–400. 2011.PubMed/NCBI

6 

Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, et al: Radiotherapy plus concomitant and adjuvant temozolamide for glioblastoma. N Engl J Med. 352:987–996. 2005. View Article : Google Scholar : PubMed/NCBI

7 

Cohen MH, Shen YL, Keegan P and Pazdur R: FDA drug approval summary: Bevacizumab (Avastin) as treatment of recurrent glioblastoma multiforme. Oncologist. 14:1131–1138. 2009. View Article : Google Scholar : PubMed/NCBI

8 

Maxwell M, Naber SP, Wolfe HJ, Hedley-Whyte ET, Galanopoulos T, Neville-Golden J and Antoniades HN: Expression of angiogenic growt factor genes in primary human astrocytomas may contribuye to their growt and progression. Cancer Res. 51:1345–1351. 1991.PubMed/NCBI

9 

Takahasi JA, Fukumoto M, Igarashi K, Oda Y, Kikuchi H and Hatanaka M: Correlation of basic fibroblast growt factor expresión levels with the degree of malignancy and vascularity in human gliomas. J Neurosurg. 76:792–798. 1992. View Article : Google Scholar : PubMed/NCBI

10 

Friedman HS, Prados MD, Wen PY, Mikkelsen T, Schiff D, Abrey LE, Yung WK, Paleologos N, Nicholas MK, Jensen R, et al: Bevacizumab alone and in combiantion with irinotecan in recurrent glioblastoma. J Clin Oncol. 27:4733–4740. 2009. View Article : Google Scholar : PubMed/NCBI

11 

Norden AD, Young GS, Setayesh K, Muzikansky A, Klufas R, Ross GL, Ciampa AS, Ebbeling LG, Levy B, Drappatz J, et al: Bevacizumab for recurrent malignant gliomas: Efficacy, toxicity, and patterns of recurrence. Neurology. 70:779–787. 2008. View Article : Google Scholar : PubMed/NCBI

12 

Kreisl TN, Kim L, Moore K, Duic P, Royce C, Stroud I, Garren N, Mackey M, Butman JA, Camphausen K, et al: Phase II trial of single-agent bevacizumab followed by bevacizumab plus irinotecan at tumor progression in recurrent glioblastoma. J Clin Oncol. 27:740–745. 2009. View Article : Google Scholar : PubMed/NCBI

13 

Vredenburgh JJ, Desjardins A, Herndon JE II, Marcello J, Reardon DA, Quinn JA, Quinn JA, Rich JN, Sathornsumetee S, Gururangan S, et al: Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol. 25:4722–4729. 2007. View Article : Google Scholar : PubMed/NCBI

14 

Zuniga RM, Torcuator R, Jain R, Anderson J, Doyle T, Ellika S, Schultz L and Mikkelsen T: Efficacy and patterns of response and recurrence in patines with recurrent high-grade gliomas treated with bevacizumab plus irinotecan. J Neurooncol. 91:329–336. 2009. View Article : Google Scholar : PubMed/NCBI

15 

Stark-Vance V: Bevacizumab and CPT-11 in the treatment of relapsed malignant glioma. Neuro Oncol. 7:3692005.(abstr 342).

16 

Raval S, Hwang S and Dorsett L: Bevacizumab and irinotecan in patients with recurrent glioblastoma multiforme (GBM). J Clin Oncol. 25(Suppl): abstract 2078. 2007.

17 

Vredenburgh JJ, Desjardins A, Herndon JE II, Dowell JM, Reardon DA, Quinn JA, Rich JN, Sathornsumetee S, Gururangan S, Wagner M, et al: Phase II trial of bevacizumab and irinotecan in recurrent malignant glioma. Clin Cancer Res. 13:1253–1259. 2007. View Article : Google Scholar : PubMed/NCBI

18 

Ali SA, McHayleh WM, Ahmad A, Sehgal R, Braffet M, Rahman M, Bejjani G and Friedland DM: Bevacizumab and irinotecan therapy in glioblastoma multiforme: A series of 13 cases. J Neurosurg. 109:268–272. 2008. View Article : Google Scholar : PubMed/NCBI

19 

Bokstein F, Shpigel S and Blumenthal DT: Treatment with bevacizumab and irinotecan for recurrent high-grade glial tumors. Cancer. 112:2267–2273. 2008. View Article : Google Scholar : PubMed/NCBI

20 

Cloughesy TF, Prados MD, Wen PY, Mikkelsen T, Abrey LE, Schiff D, Yung WK, Maoxia Z, Dimery I and Friedman HS: A phase II, randomized, non-comparative clinical trial of the effect of bevacizumab (BV) alone or in combination with irinotecan (CPT) on 6-month progression free survival (PFS6) in recurrent, treatment refractory glioblastoma (GBM). J Clin Oncol. 26(Suppl): abstract 2010b. 2008.PubMed/NCBI

21 

Desjardins A, Reardon DA, Herndon JE II, Marcello J, Quinn JA, Rich JN, Sathornsumetee S, Gururangan S, Sampson J, Bailey L, et al: Bevacizumab plus irinotecan in recurrent WHO grade 3 malignant gliomas. Clin Cancer Res. 14:7068–7073. 2008. View Article : Google Scholar : PubMed/NCBI

22 

Guiu S, Taillibert S, Chinot O, Taillandier L, Honnorat J, Dietrich PY, Maire JP, Guillamo JS, Guiu B, Catry-Thomas I, et al: Bevacizumab/irinotecan. An active treatment for recurrent high grade gliomas: Preliminary results of an ANOCEF multicenter study. Rev Neurol (Paris). 164:588–594. 2008.(In French). View Article : Google Scholar : PubMed/NCBI

23 

Gilbert MR, Wang M, Aldape K, Lassman A, Sorensen AG, Mikkelson T, Groves M, Werner-Wasik M, Regine W and Mehta M: RTOG 0625: A phase II study of bevacizumab with irinotecan in recurrent glioblastoma (GBM). J Clin Oncol. 27(Suppl): abstract 2011. 2009.

24 

Nghiemphu PL, Liu W, Lee Y, Than T, Graham C, Lai A, Green RM, Pope WB, Liau LM, Mischel PS, et al: Bevacizumab and chemotherapy for recurrent glioblastoma: A single-institution experience. Neurology. 72:1217–1222. 2009. View Article : Google Scholar : PubMed/NCBI

25 

Poulsen HS, Grunnet K, Sorensen M, Olsen P, Hasselbalch B, Nelausen K, Kosteljanetz M and Lassen U: Bevacizumab plus irinotecan in the treatment patients with progressive recurrent malignant brain tumours. Acta Oncol. 48:52–58. 2009. View Article : Google Scholar : PubMed/NCBI

26 

Cloughesy T, Vredenburgh JJ, Day B, Das A and Friedman HS: Updated safety and survival of patients with relapsed glioblastoma treated with bevacizumab in the BRAIN study. J Clin Oncol. 28(Suppl): abstract 2008. 2010.PubMed/NCBI

27 

Ruiz-Sánchez D, Calero MA, Sastre-Heres AJ, García MT, Hernandez MA, Martinez FM and Peña-Díaz J: Effectiveness of the bevacizumab-irinotecan regimen in the treatment of recurrent glioblastomamultiforme: Comparison with other second-line treatments without this regimen. Oncol Lett. 4:1114–1118. 2012.PubMed/NCBI

28 

Henriksson R, Asklund T and Poulsen HS: Impact of therapy on quality of life, neurocognitive function and their correlates in glioblastoma multiforme: A review. J Neurooncol. 104:639–646. 2011. View Article : Google Scholar : PubMed/NCBI

29 

Lamers LM, Stupp R, van den Bent MJ, Al MJ, Gorlia T, Wasserfallen JB, Mittmann N, Jin Seung S, Crott R and Uyl-de Groot CA: EORTC 26981/22981 NCI-C CE3 Intergroup Study: Cost-effectiveness of temozolomide for the treatment of newly diagnosed glioblastoma multiforme. A report from the EORTC 26981/22981 NCI-C CE3 intergroup study. Cancer. 112:1337–1344. 2008. View Article : Google Scholar : PubMed/NCBI

30 

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW and Kleihues P: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114:97–109. 2007. View Article : Google Scholar : PubMed/NCBI

31 

Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET and Carbone PP: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI

32 

McCabe C, Claxton K and Culyer AJ: The NICE cost-effectiveness threshold: What it is and what that means. Pharmacoeconomics. 26:733–744. 2008. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Ruiz‑Sánchez D, Peinado II, Alaguero‑Calero M, Sastre‑Heres AJ, Diez BG and Peña‑Díaz J: Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences. Oncol Lett 12: 1935-1940, 2016.
APA
Ruiz‑Sánchez, D., Peinado, I.I., Alaguero‑Calero, M., Sastre‑Heres, A.J., Diez, B.G., & Peña‑Díaz, J. (2016). Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences. Oncology Letters, 12, 1935-1940. https://doi.org/10.3892/ol.2016.4871
MLA
Ruiz‑Sánchez, D., Peinado, I. I., Alaguero‑Calero, M., Sastre‑Heres, A. J., Diez, B. G., Peña‑Díaz, J."Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences". Oncology Letters 12.3 (2016): 1935-1940.
Chicago
Ruiz‑Sánchez, D., Peinado, I. I., Alaguero‑Calero, M., Sastre‑Heres, A. J., Diez, B. G., Peña‑Díaz, J."Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences". Oncology Letters 12, no. 3 (2016): 1935-1940. https://doi.org/10.3892/ol.2016.4871
Copy and paste a formatted citation
x
Spandidos Publications style
Ruiz‑Sánchez D, Peinado II, Alaguero‑Calero M, Sastre‑Heres AJ, Diez BG and Peña‑Díaz J: Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences. Oncol Lett 12: 1935-1940, 2016.
APA
Ruiz‑Sánchez, D., Peinado, I.I., Alaguero‑Calero, M., Sastre‑Heres, A.J., Diez, B.G., & Peña‑Díaz, J. (2016). Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences. Oncology Letters, 12, 1935-1940. https://doi.org/10.3892/ol.2016.4871
MLA
Ruiz‑Sánchez, D., Peinado, I. I., Alaguero‑Calero, M., Sastre‑Heres, A. J., Diez, B. G., Peña‑Díaz, J."Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences". Oncology Letters 12.3 (2016): 1935-1940.
Chicago
Ruiz‑Sánchez, D., Peinado, I. I., Alaguero‑Calero, M., Sastre‑Heres, A. J., Diez, B. G., Peña‑Díaz, J."Cost-effectiveness analysis of the bevacizumab-irinotecan regimen in the treatment of primary glioblastoma multiforme recurrences". Oncology Letters 12, no. 3 (2016): 1935-1940. https://doi.org/10.3892/ol.2016.4871
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