BIOMAT Database Logo BIOMAT Database Logo

Economic analysis: randomized placebo-controlled clinical trial of erlotinib in advanced non-small cell lung cancer. 2010

Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
NCIC Clinical Trials Group, Kingston, ON, Canada.

BACKGROUND The NCIC Clinical Trials Group conducted the BR.21 trial, a randomized placebo-controlled trial of erlotinib (an epidermal growth factor receptor tyrosine kinase inhibitor) in patients with previously treated advanced non-small cell lung cancer. This trial accrued patients between August 14, 2001, and January 31, 2003, and found that overall survival and quality of life were improved in the erlotinib arm than in the placebo arm. However, funding restrictions limit access to erlotinib in many countries. We undertook an economic analysis of erlotinib treatment in this trial and explored different molecular and clinical predictors of outcome to determine the cost-effectiveness of treating various populations with erlotinib. METHODS Resource utilization was determined from individual patient data in the BR.21 trial database. The trial recruited 731 patients (488 in the erlotinib arm and 243 in the placebo arm). Costs arising from erlotinib treatment, diagnostic tests, outpatient visits, acute hospitalization, adverse events, lung cancer-related concomitant medications, transfusions, and radiation therapy were captured. The incremental cost-effectiveness ratio was calculated as the ratio of incremental cost (in 2007 Canadian dollars) to incremental effectiveness (life-years gained). In exploratory analyses, we evaluated the benefits of treatment in selected subgroups to determine the impact on the incremental cost-effectiveness ratio. RESULTS The incremental cost-effectiveness ratio for erlotinib treatment in the BR.21 trial population was $94,638 per life-year gained (95% confidence interval = $52,359 to $429,148). The major drivers of cost-effectiveness included the magnitude of survival benefit and erlotinib cost. Subgroup analyses revealed that erlotinib may be more cost-effective in never-smokers or patients with high EGFR gene copy number. CONCLUSIONS With an incremental cost-effectiveness ratio of $94 638 per life-year gained, erlotinib treatment for patients with previously treated advanced non-small cell lung cancer is marginally cost-effective. The use of molecular predictors of benefit for targeted agents may help identify more or less cost-effective subgroups for treatment.

UI MeSH Term Description Entries
D007391 International Cooperation The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest. Foreign Aid,Treaties,Aid, Foreign,Cooperation, International,Treaty
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011505 Protein-Tyrosine Kinases Protein kinases that catalyze the PHOSPHORYLATION of TYROSINE residues in proteins with ATP or other nucleotides as phosphate donors. Tyrosine Protein Kinase,Tyrosine-Specific Protein Kinase,Protein-Tyrosine Kinase,Tyrosine Kinase,Tyrosine Protein Kinases,Tyrosine-Specific Protein Kinases,Tyrosylprotein Kinase,Kinase, Protein-Tyrosine,Kinase, Tyrosine,Kinase, Tyrosine Protein,Kinase, Tyrosine-Specific Protein,Kinase, Tyrosylprotein,Kinases, Protein-Tyrosine,Kinases, Tyrosine Protein,Kinases, Tyrosine-Specific Protein,Protein Kinase, Tyrosine-Specific,Protein Kinases, Tyrosine,Protein Kinases, Tyrosine-Specific,Protein Tyrosine Kinase,Protein Tyrosine Kinases,Tyrosine Specific Protein Kinase,Tyrosine Specific Protein Kinases
D011799 Quinazolines A group of aromatic heterocyclic compounds that contain a bicyclic structure with two fused six-membered aromatic rings, a benzene ring and a pyrimidine ring. Quinazoline
D002170 Canada The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.
D002289 Carcinoma, Non-Small-Cell Lung A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy. Carcinoma, Non-Small Cell Lung,Non-Small Cell Lung Cancer,Non-Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinoma,Nonsmall Cell Lung Cancer,Carcinoma, Non Small Cell Lung,Carcinomas, Non-Small-Cell Lung,Lung Carcinoma, Non-Small-Cell,Lung Carcinomas, Non-Small-Cell,Non Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinomas
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D005260 Female Females

Related Publications

Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Pharmacogenetic analysis of BR.21, a placebo-controlled randomized phase III clinical trial of erlotinib in advanced non-small cell lung cancer.
February 2012, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Randomized, double-blind, placebo-controlled, phase II trial of sorafenib and erlotinib or erlotinib alone in previously treated advanced non-small-cell lung cancer.
June 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Randomized Phase II Trial of Erlotinib Beyond Progression in Advanced Erlotinib-Responsive Non-Small Cell Lung Cancer.
November 2015, The oncologist,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Maintenance erlotinib improves clinical outcomes of unresectable advanced non-small cell lung cancer: A meta-analysis of randomized controlled trials.
November 2012, Experimental and therapeutic medicine,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Clinical and economic review of erlotinib in non-small-cell lung cancer.
August 2012, Expert review of pharmacoeconomics & outcomes research,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Randomized, placebo-controlled, phase II study of sequential erlotinib and chemotherapy as first-line treatment for advanced non-small-cell lung cancer.
October 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Bevacizumab plus erlotinib versus erlotinib alone for advanced EGFR-mutant non-small cell lung cancer: a meta-analysis of randomized clinical trials.
August 2023, European journal of medical research,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Erlotinib (Tarceva) for advanced non-small cell lung cancer.
March 2005, The Medical letter on drugs and therapeutics,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Randomized phase 2 trial of erlotinib in combination with high-dose celecoxib or placebo in patients with advanced non-small cell lung cancer.
September 2015, Cancer,
Penelope A Bradbury, and Dongsheng Tu, and Lesley Seymour, and Pierre K Isogai, and Liting Zhu, and Raymond Ng, and Nicole Mittmann, and Ming-Sound Tsao, and William K Evans, and Frances A Shepherd, and Natasha B Leighl, and
Sunitinib plus erlotinib versus placebo plus erlotinib in patients with previously treated advanced non-small-cell lung cancer: a phase III trial.
June 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
Copied contents to your clipboard!