Evidence map›Paper›PMID 30196427›Full record

ReviewInternational journal of colorectal disease2018

First-line therapies in metastatic colorectal cancer: integrating clinical benefit with the costs of drugs.

Jacopo Giuliani, Andrea Bonetti

Abstract readReview
PubMed Publisher
In one paragraph

Review in International journal of colorectal disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 31% of its field
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

4 citing papers in PubMed, 18 citations in OpenAlex.

  1. The Current Role of Antiangiogenics in Colorectal Cancer.International journal of molecular sciences · 2025
    Review
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  3. Review
  4. Article
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

2 authors at 1 institution in 1 country.

Jacopo GiulianiDepartment of Oncology, Mater Salutis Hospital-Az. ULSS 9 Scaligera, Via Gianella 1-37045, Legnago, VR, Italy. giuliani.jacopo@alice.it.
Andrea BonettiDepartment of Oncology, Mater Salutis Hospital-Az. ULSS 9 Scaligera, Via Gianella 1-37045, Legnago, VR, Italy.
ATS Sardegna (Italy) · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn light of the relevant expenses of pharmacological interventions, it might be interesting to make a balance between the cost of the new drugs administered and the added value represented by the improvement in progression free survival (PFS) in first-line for metastatic colorectal cancer CRC (mCRC).

methodsPhase III randomized controlled trials (RCTs) that compared at least two first-line chemotherapy regimens for mCRC patients were evaluated. Differences in PFS between the different arms were compared with the pharmacological costs (at the pharmacy of our hospital). The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) was applied to the above RCTs.

resultsOverall 28 phase III RCTs, including 19,958 patients, were analyzed. The FOLFOX resulted the least expensive (56 € per month of PFS gained) while the addition of irinotecan to FOLFOX (FOLFOXIRI) increased only marginally the costs (90 € per month of PFS gained). Treatments including the monoclonal antibodies showed a cost per month of PFS gained of 2823 € (FOLFIRI with cetuximab in KRAS wild-type patients and liver-only metastases), of € 15,822 (FOLFOX with panitumumab in KRAS wild type), and of 13,383 € (FOLFOX with bevacizumab). According to the ESMO-MCBS, the treatments including an EGFR-inhibitor (cetuximab or panitumumab) were associated with a score of 4, while the inclusion of bevacizumab reached a score of 3.

conclusionsOur data demonstrate a huge difference in cost per month of PFS gained in modern first-line treatments in mCRC.

Indexed as

Antineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsHumansNeoplasm StagingProgression-Free SurvivalRandomized Controlled Trials as TopicTreatment OutcomeAntineoplastic AgentsCosts of drugsESMO-MCBSFirst-line therapyMetastatic colorectal cancerRandomized phase III trials

Identifiers

PMID30196427
OpenAlexW2892376819

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.