Specific sequence of drugs reduces cost of treating metastatic breast cancer while preserving quality of life

Medical Xpress / UNC Lineberger Comprehensive Cancer Center / Journal of Clinical Oncology ^ | Sept. 13, 2022 | Stephanie B. Wheeler et al

[ConservativeMind]

Giving standard chemotherapy drugs in a specific sequence for some types of metastatic breast cancer can help reduce overall costs and improve the value of care while preserving quality of life.

Currently, there are many chemotherapy choices to treat metastatic breast cancer. Oncologists have some preferences of which drugs to use early in treatment, but there is little clear evidence on the best order in which to give the drugs.

The purpose of the study was to test whether putting the drugs in one sequence compared to another could keep the patient on treatment for similar times while decreasing their side effect and/or cost burden.

The costs calculated were inclusive of medical and nonmedical costs borne by patients, including lost productivity. In this simulation, after two years, nearly all women would have completed the first three sets of treatment, but the cancer would cause the death of about one-third of the women. Productivity days lost due to sickness were similar across chemotherapy sequences, so most of the cost difference was due to drug savings. In the simulation, patients were placed in three groups, depending on what treatments they had already received.

Outcomes in the three groups were:

For people who had not previously received the common chemotherapy drug categories, including a taxane (e.g., paclitaxel) or an anthracycline (e.g., capecitabine), treatment with paclitaxel then capecitabine followed by doxorubicin corresponded to the highest expected gains in quality of life and lowest costs.

For people who had previously received a taxane and an anthracycline drug, treatment with carboplatin, followed by capecitabine, followed by eribulin, corresponded to the highest expected gains in quality of life and lowest costs.

For people who had previously received a taxane but not an anthracycline, treatment sequences beginning with capecitabine or doxorubicin, followed by eribulin, were most cost-effective.

[ConservativeMind]

This was found to not greatly affect outcomes, but did primarily note the sequences found ways to optimize costs, which makes sense in a financial model approach.

They did stress any newly available therapy could change the results and they encouraged doctors to integrate them into a similar approach, so they do not want this to be a static approach.

[deport]

H E L P

[ConservativeMind]

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