lunes, 6 de mayo de 2013

A prospective clinical utility and pharmacoecon... [Eur J Cancer. 2013] - PubMed - NCBI

A prospective clinical utility and pharmacoecon... [Eur J Cancer. 2013] - PubMed - NCBI

Eur J Cancer. 2013 Apr 20. pii: S0959-8049(13)00211-6. doi: 10.1016/j.ejca.2013.03.009. [Epub ahead of print]

A prospective clinical utility and pharmacoeconomic study of the impact of the 21-gene Recurrence Score® assay in oestrogen receptor positive node negative breast cancer.

Source

Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada.

Abstract

PURPOSE:

The primary purpose of this study was to measure the impact of the 21-gene Recurrence Score® result on systemic treatment recommendations and to perform a prospective health economic analysis in stage I-II, node-negative, oestrogen receptor positive (ER+) breast cancer.

METHODS:

Consenting patients with ER+ node negative invasive breast cancer and their treating medial oncologists were asked to complete questionnaires about treatment preferences, level of confidence in those preferences and a decisional conflict scale (patients only) after a discussion of their diagnosis and risk without knowledge of the Recurrence Score. At a subsequent visit, the assay result and final treatment recommendations were discussed prior to both parties completing a second set of questionnaires. A Markov health state transition model was constructed, simulating the costs and outcomes experienced by a hypothetical 'assay naïve' population and an 'assay informed' population.

RESULTS:

One hundred and fifty-six patients across two cancer centres were enrolled. Of the 150 for whom successful assay results were obtained, physicians changed their chemotherapy recommendations in 45 cases (30%; 95% confidence interval (CI) 22.8-38.0%); either to add (10%; 95% CI 5.7-16.0%) or omit (20%; 95% CI 13.9-27.3%) adjuvant chemotherapy. There was an overall significant improvement in physician confidence post-assay (p<0 .001="" also="" an="" assay="" canadian="" conflict="" cost-effectiveness="" decisional="" decreased="" dollars="" following="" found="" incremental="" life="" model="" of="" p="" patient="" quality-adjusted="" ratio="" significantly="" simulation="" the="" years="">

CONCLUSION:

Within the context of a publicly funded health care system, the Recurrence Score assay significantly affects adjuvant treatment recommendations and is cost effective in ER+ node negative breast cancer.
Copyright © 2013. Published by Elsevier Ltd.
PMID:
23611660
[PubMed - as supplied by publisher]

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