Evidence map›Paper›PMID 25022528›Full record

ArticleAdvances in therapy2014

Cost-effectiveness of second-line chemotherapy/biologics among elderly metastatic colon cancer patients.

Zhiyuan Zheng, Eberechukwu Onukwugha, Nader Hanna, Kaloyan Bikov, Brian Seal, C Daniel Mullins

Abstract read
In one paragraph

Article in Advances in therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Zhiyuan ZhengUniversity of Maryland School of Pharmacy, Baltimore, MD, USA, jason.zheng@cancer.org.
Eberechukwu Onukwugha
Nader Hanna
Kaloyan Bikov
Brian Seal
C Daniel Mullins

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAdvancements in chemotherapy treatment have improved the clinical management of metastatic colon cancer (mCC) patients. An increasing number of elderly mCC patients receive various combinations of regimens in second-line chemotherapy/biologics treatment (Tx2) after first-line treatment (Tx1) to prolong survival and/or palliate symptoms, but these regimens have higher costs. This analysis investigated the survival benefit and incremental cost associated with Tx2 among elderly mCC patients.

methodsElderly (aged ≥66 years) SEER-Medicare patients diagnosed with mCC in 2003-2007 were identified and followed until death or the end of 2009. Cox regression and partitioned least squares regression were utilized to obtain the survival benefit and incremental cost associated with Tx2 within a 5-year study period. A time-varying model was used to reduce bias due to sequential ordering of Tx1 and Tx2. The regressions controlled for patient demographic characteristics, clinical variables, and a proxy for poor performance. Bootstrapping was used to generate 95% confidence intervals (CI).

resultsOf the 3,266 elderly mCC patients who received Tx1, 2,744 (84%) died within the observation period; 1,440 (44%) received Tx2. The survival benefit associated with receipt of Tx2 was 0.33 years (95% CI 0.19-0.43), and the associated incremental cost was $40,888 (95% CI 3,044-44,324). The incremental cost-effectiveness ratio (ICER) for Tx2 was $123,903 per life year gained (95% CI 9,600-216,082).

conclusionThe estimated survival benefit of receiving second-line chemotherapy/biologics was about 4 months, which is consistent with evidence from clinical trials. This improved survival was associated with an ICER that exceeds the traditional threshold.

Indexed as

AgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsBiological ProductsColonic NeoplasmsCost-Benefit AnalysisFemaleHumansMaleMedicareNeoplasm MetastasisSEER ProgramSurvival AnalysisUnited StatesBiological Products

Identifiers

PMID25022528
PMCPMC4115177

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