ArticleApplied health economics and health policy2018
Consequences of Biomarker Analysis on the Cost-Effectiveness of Cetuximab in Combination with FOLFIRI as a First-Line Treatment of Metastatic Colorectal Cancer: Personalised Medicine at Work.
Article in Applied health economics and health policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 5 of them syntheses that pooled it.
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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.
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Who cites it
7 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The Cost Effectiveness of Genomic Medicine in Cancer Control: A Systematic Literature Review.Applied health economics and health policy · 2025Pooled it
- Economic Evaluation of Monoclonal Antibodies in Metastatic Colorectal Cancer: A Systematic Review.Molecular diagnosis & therapy · 2021Pooled it
- How are we evaluating the cost-effectiveness of companion biomarkers for targeted cancer therapies? A systematic review.BMC cancer · 2021Pooled it
- Health Economic Models for Metastatic Colorectal Cancer: A Methodological Review.PharmacoEconomics · 2020Pooled it
- Do cancer biomarkers make targeted therapies cost-effective? A systematic review in metastatic colorectal cancer.PloS one · 2018Pooled it
- Using Genomic Heterogeneity to Inform Therapeutic Decisions for Metastatic Colorectal Cancer: An Application of the Value of Heterogeneity Framework.Applied health economics and health policy · 2025Article
- Molecular biomarkers and precision medicine in colorectal cancer: a systematic review of health economic analyses.Oncotarget · 2019Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTherapies may be more efficacious when targeting a patient subpopulation with specific attributes, thereby enhancing the cost-effectiveness of treatment. In the CRYSTAL study, patients with metastatic colorectal cancer (mCRC) were treated with cetuximab plus FOLFIRI or FOLFIRI alone until disease progression, unacceptable toxic effects or withdrawal of consent.
objectiveTo determine if stratified use of cetuximab based on genetic biomarker detection improves cost-effectiveness.
methodsWe used individual patient data from CRYSTAL to compare the cost-effectiveness, cost per life-year (LY) and cost per quality-adjusted LY (QALY) gained of cetuximab plus FOLFIRI versus FOLFIRI alone in three cohorts of patients with mCRC: all randomised patients (intent-to-treat; ITT), tumours with no detectable mutations in codons 12 and 13 of exon 2 of the KRAS protein ('KRAS wt') and no detectable mutations in exons 2, 3 and 4 of KRAS and exons 2, 3 and 4 of NRAS ('RAS wt'). Survival analysis was conducted using RStudio, and a cost-utility model was modified to allow comparison of the three cohorts.
resultsThe deterministic base-case ICER (cost per QALY gained) was £130,929 in the ITT, £72,053 in the KRAS wt and £44,185 in the RAS wt cohorts for cetuximab plus FOLFIRI compared with FOLFIRI alone. At a £50,000 willingness-to-pay threshold, cetuximab plus FOLFIRI has a 2.8, 20 and 63% probability of being cost-effective for the ITT, KRAS wt and RAS wt cohorts, respectively, versus FOLFIRI alone.
conclusionScreening for mutations in both KRAS and NRAS may provide the most cost-effective approach to patient selection.
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