ArticleJournal of neuro-oncology2019
Cost-effectiveness of tumor-treating fields added to maintenance temozolomide in patients with glioblastoma: an updated evaluation using a partitioned survival model.
Article in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global economic differences in modern glioblastoma care - a systematic review.Acta neurochirurgica · 2026Pooled it
- Neuromodulation in Neuro-Oncology: A Scoping Review.Journal of personalized medicine · 2026Review
- Tumor Treating Fields and the Glioblastoma Microenvironment: Mechanistic Convergences with Radiotherapy.Cancers · 2026Review
- Methodological aspects of economic evaluations and health economic models in glioblastoma: A systematic literature review.Neuro-oncology practice · 2026Review
- Impact of alternating electric fields therapy for newly diagnosed WHO grade 4 astrocytoma on patient survival: a real-world propensity-score adjusted prospective multicenter study.Journal of neuro-oncology · 2025Article
- Recent advances in Tumor Treating Fields (TTFields) therapy for glioblastoma.The oncologist · 2025Review
- Sugemalimab plus chemotherapy vs. chemotherapy for treatment of Chinese patients with esophageal squamous cell carcinoma: a cost effectiveness analysis to inform decision making.Frontiers in oncology · 2025Article
- Review
- Cost of medical care for malignant brain tumors at hospitals in the Japan Clinical Oncology Group brain-tumor study group.Japanese journal of clinical oncology · 2024Article
- Combination tumor-treating fields treatment for patients with metastatic non-small cell lung cancer: A cost-effectiveness analysis.Cancer medicine · 2024Article
- Cost-effectiveness of tumor-treating fields plus standard therapy for advanced non-small cell lung cancer progressed after platinum-based therapy in the United States.Frontiers in pharmacology · 2024Article
- Cost-effectiveness analysis of Tumor Treating Fields treatment in Chinese patients with metastatic non-small cell lung cancer.Frontiers in public health · 2024Article
- Review
- Review
- The Routine Application of Tumor-Treating Fields in the Treatment of Glioblastoma WHO° IV.Frontiers in neurology · 2022Article
- Tumor-Treating Fields for the treatment of glioblastoma: a systematic review and meta-analysis.Neuro-oncology practice · 2021Review
- Tumor-Treating Fields Therapy for Pediatric Brain Tumors.Neurology international · 2021Review
- Challenges and Perspectives of Standard Therapy and Drug Development in High-Grade Gliomas.Molecules (Basel, Switzerland) · 2021Review
- Tumour treating fields therapy for glioblastoma: current advances and future directions.British journal of cancer · 2021Review
- Cost-Effectiveness of Short-Course Radiation Plus Temozolomide for the Treatment of Newly Diagnosed Glioblastoma Among Elderly Patients in China and the United States.Frontiers in pharmacology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA first cost-effectiveness analysis has raised a strong concern regarding the cost of tumor treatment fields (TTF) added to maintenance temozolomide for patients with glioblastoma. This evaluation was based on effectiveness outcomes from an interim analysis of the pivotal trial, moreover it used a "standard" Markov model. Our objective was to update the cost-effectiveness evaluation using the more flexible potential of the "partitioned survival" model design and using the latest effectiveness data.
methodsWe developed the model with three mutually exclusive health states: stable disease, progressive disease, and dead. Good fit parametric models were developed for overall survival and progression free survival and these generated clinically plausible extrapolations beyond the observed data. We adopted the perspective of the French national health insurance and used a 20-year time horizon. Results were expressed as cost/life-years (LY) gained (LYG).
resultsThe base case model generated incremental benefit of 0.604 LY at a cost of €453,848 which, after 4% annual discounting of benefits and costs, yielded an incremental cost effectiveness ratio (ICER) of €510,273/LYG. Using sensitivity analyses and bootstrapping methods results were found to be relatively robust and were only sensitive to TTF device costs and the modelling of overall survival. To achieve an ICER below €100,000/LYG would require a reduction in TTF device cost of approximately 85%.
conclusionsUsing a different type of model and updated survival outcomes, our results show TTF remains an intervention that is not cost-effective, which greatly restrains its diffusion to potentially eligible patients.
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