Pancreatic cancer - cost for overtreatment with gemcitabine.
(2013) In Acta Oncologica 52(6). p.1146-1151- Abstract
- Gemcitabine has been the standard chemotherapeutic agent in pancreatic cancer. However, two-thirds of pancreatic tumors display low expression of human equilibrative nucleoside transporter 1 (hENT1), which mediates cellular entry of the drug, and do not respond to gemcitabine therapy. The objective was to determine the costs of gemcitabine overtreatment and the cost-effectiveness of hENT1 testing using a Swedish pancreatic cancer cohort. Material and methods. The study population included 87 patients that were diagnosed with pancreatic cancer during 2008-2010 at Skåne University Hospital, Lund. A detailed review of treatments, side effects and resource utilization was performed. The proportion of hENT1-low was estimated at two-thirds based... (More)
- Gemcitabine has been the standard chemotherapeutic agent in pancreatic cancer. However, two-thirds of pancreatic tumors display low expression of human equilibrative nucleoside transporter 1 (hENT1), which mediates cellular entry of the drug, and do not respond to gemcitabine therapy. The objective was to determine the costs of gemcitabine overtreatment and the cost-effectiveness of hENT1 testing using a Swedish pancreatic cancer cohort. Material and methods. The study population included 87 patients that were diagnosed with pancreatic cancer during 2008-2010 at Skåne University Hospital, Lund. A detailed review of treatments, side effects and resource utilization was performed. The proportion of hENT1-low was estimated at two-thirds based on previous evaluations of tumor samples from the Radiation Therapy Oncology Group (RTOG) trial 9704, the German AIO Pancreatic Cancer Group (AIO-PK) trial 0104, the Low hENT1 and Adenocarcinoma of the Pancreas (LEAP) trial and the authors' own institution. The cost of the hENT1 test was estimated at €50-200. Results. Sixty patients received gemcitabine and the other 27 best supportive care. Drug administration and hospitalization were the main expenditures. Grade 3 and 4 toxicities occurred in 42%, the most common being neutropenia (18%). The hospital costs related to gemcitabine overtreatment amounted to €5358 per pancreatic cancer patient, corresponding to as much as one-third of the total treatment cost. The health economical costs amounted to €9449 per patient when including indirect costs. Using hENT1 testing to select patients for gemcitabine therapy would save €8.6 million in Sweden each year. Conclusion. Total costs related to gemcitabine overtreatment were high. Individualizing gemcitabine treatment is cost-saving and would reduce unnecessary treatment-related toxicity. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3347147
- author
- Ansari, Daniel LU ; Tingstedt, Bobby LU and Andersson, Roland LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Oncologica
- volume
- 52
- issue
- 6
- pages
- 1146 - 1151
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000322607400012
- pmid:23244671
- scopus:84880315622
- pmid:23244671
- ISSN
- 1651-226X
- DOI
- 10.3109/0284186X.2012.744140
- language
- English
- LU publication?
- yes
- id
- aa591cac-8d16-423a-acde-f358ef76466b (old id 3347147)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23244671?dopt=Abstract
- date added to LUP
- 2016-04-01 10:09:20
- date last changed
- 2022-01-25 20:14:19
@article{aa591cac-8d16-423a-acde-f358ef76466b,
abstract = {{Gemcitabine has been the standard chemotherapeutic agent in pancreatic cancer. However, two-thirds of pancreatic tumors display low expression of human equilibrative nucleoside transporter 1 (hENT1), which mediates cellular entry of the drug, and do not respond to gemcitabine therapy. The objective was to determine the costs of gemcitabine overtreatment and the cost-effectiveness of hENT1 testing using a Swedish pancreatic cancer cohort. Material and methods. The study population included 87 patients that were diagnosed with pancreatic cancer during 2008-2010 at Skåne University Hospital, Lund. A detailed review of treatments, side effects and resource utilization was performed. The proportion of hENT1-low was estimated at two-thirds based on previous evaluations of tumor samples from the Radiation Therapy Oncology Group (RTOG) trial 9704, the German AIO Pancreatic Cancer Group (AIO-PK) trial 0104, the Low hENT1 and Adenocarcinoma of the Pancreas (LEAP) trial and the authors' own institution. The cost of the hENT1 test was estimated at €50-200. Results. Sixty patients received gemcitabine and the other 27 best supportive care. Drug administration and hospitalization were the main expenditures. Grade 3 and 4 toxicities occurred in 42%, the most common being neutropenia (18%). The hospital costs related to gemcitabine overtreatment amounted to €5358 per pancreatic cancer patient, corresponding to as much as one-third of the total treatment cost. The health economical costs amounted to €9449 per patient when including indirect costs. Using hENT1 testing to select patients for gemcitabine therapy would save €8.6 million in Sweden each year. Conclusion. Total costs related to gemcitabine overtreatment were high. Individualizing gemcitabine treatment is cost-saving and would reduce unnecessary treatment-related toxicity.}},
author = {{Ansari, Daniel and Tingstedt, Bobby and Andersson, Roland}},
issn = {{1651-226X}},
language = {{eng}},
number = {{6}},
pages = {{1146--1151}},
publisher = {{Taylor & Francis}},
series = {{Acta Oncologica}},
title = {{Pancreatic cancer - cost for overtreatment with gemcitabine.}},
url = {{http://dx.doi.org/10.3109/0284186X.2012.744140}},
doi = {{10.3109/0284186X.2012.744140}},
volume = {{52}},
year = {{2013}},
}