ArticleGynecologic oncology2020
Cost-effectiveness analysis comparing "PARP inhibitors-for-all" to the biomarker-directed use of PARP inhibitor maintenance therapy for newly diagnosed advanced stage ovarian cancer.
Article in Gynecologic oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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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.
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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Homologous Recombination Deficiency Testing to Inform Patient Decisions About Niraparib Maintenance Therapy for High-Grade Serous or Endometrioid Epithelial Ovarian Cancer: A Health Technology Assessment.Ontario health technology assessment series · 2023Pooled it
- Cost-Effectiveness of Poly ADP-Ribose Polymerase Inhibitors in Cancer Treatment: A Systematic Review.Frontiers in pharmacology · 2022Pooled it
- Pooled it
- Prognostic Nomogram for Ovarian Cancer Patients on First-Line Maintenance Therapy With PARP Inhibitors: A Retrospective Cohort Study.Cancer medicine · 2026Article
- Treatment, outcomes, and resource utilization among patients with metastatic breast and advanced epithelial ovarian cancer, by BRCA1/2 and HRD status.The oncologist · 2025Article
- Precision Medicine in High-Grade Serous Ovarian Cancer: Targeted Therapies and the Challenge of Chemoresistance.International journal of molecular sciences · 2025Review
- Predictive biomarkers for the efficacy of PARP inhibitors in ovarian cancer: an updated systematic review.BJC reports · 2025Article
- Challenges and opportunities to address the emerging burden of targeted therapies in ovarian cancer.Gynecologic oncology reports · 2025Review
- Whole exome sequencing-based homologous recombination deficiency test for epithelial ovarian cancer.Journal of ovarian research · 2025Article
- Significance of CA125 Monitoring during Maintenance Treatment with Poly(ADP-Ribose) Polymerase Inhibitor in Ovarian Cancer after First-Line Chemotherapy: Multicenter, Observational Study.Oncology research · 2025Observational
- Cost-Effectiveness Analysis of HRD Testing for Previously Treated Patients with Advanced Ovarian Cancer in Italy.Advances in therapy · 2024Article
- Cost-Effectiveness Analysis of Biomarker Testing to Guide First-Line PARP Inhibitor Maintenance for Patients with Advanced Ovarian Cancer After Response to First-Line Platinum Chemotherapy in the USA.Targeted oncology · 2023Article
- PARP Inhibitors in Breast and Ovarian Cancer.Cancers · 2023Review
- Cost-Effectiveness Analysis of Germline and SomaticAnnals of laboratory medicine · 2023Article
- Cost-Effectiveness Analysis of Olaparib in Combination with Bevacizumab Compared with Bevacizumab Monotherapy for the First-Line Maintenance Treatment of Homologous Recombination Deficiency-Positive Advanced Ovarian Cancer.PharmacoEconomics - open · 2022Article
- Maintenance therapy for newly diagnosed epithelial ovarian cancer- a review.Journal of ovarian research · 2022Review
- Appropriate Selection of PARP Inhibitors in Ovarian Cancer.Current treatment options in oncology · 2022Review
- Cytotoxic and targeted therapy for BRCA1/2-driven cancers.Hereditary cancer in clinical practice · 2021Review
- Homologous Recombination Deficiency Assays in Epithelial Ovarian Cancer: Current Status and Future Direction.Frontiers in oncology · 2021Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesClinical trials evaluating universal PARP inhibitor (PARPi) frontline maintenance therapy for advanced stage ovarian cancer have reported progression-free survival (PFS) benefit. It is unclear whether PARPi maintenance therapy will universally enhance value (clinical benefits relative to cost of delivery). We compared a "PARPi-for-all" to a biomarker-directed frontline maintenance therapy approach as a value-based care strategy.
methodsThe cost of two frontline PARPi maintenance strategies, PARPi-for-all and biomarker-directed maintenance, was compared using modified Markov decision models simulating the study designs of the PRIMA, VELIA, and, PAOLA-1 trials. Outcomes of interest included overall costs and incremental cost-effectiveness ratios (ICERs) reported in US dollars per quality adjusted progression-free life-year (QA-PFY) gained.
resultsPARPi-for-all was more costly and provided greater PFS benefit than a biomarker-directed strategy for each trial. The mean cost per patient for the PARPi-for-all strategy was $166,269, $286,715, and $366,506 for the PRIMA, VELIA, and PAOLA-1 models, respectively. For the biomarker-directed strategy, the mean cost per patient was $98,188, $167,334, and $260,671 for the PRIMA, VELIA, and PAOLA-1 models. ICERs of PARPi-for-all compared to biomarker-directed maintenance were: $593,250/QA-PFY (PRIMA), $1,512,495/QA-PFY (VELIA), and $3,347,915/QA-PFY (PAOLA-1). At current drug pricing, there is no PFS improvement in a biomarker negative cohort that would make PARPi-for-all cost-effective compared to biomarker-directed maintenance.
conclusionsThis study highlights the high costs of universal PARPi maintenance treatment, compared with a biomarker-directed PARPi strategy. Maintenance therapy in the front-line setting should be reserved for those with germline or somatic HRD mutations until the cost of therapy is significantly reduced.
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