Evidence map›Paper›PMID 35205656›Full record

ArticleCancers2022

Cost-Effectiveness of Molecularly Guided Treatment in Diffuse Large B-Cell Lymphoma (DLBCL) in Patients under 60.

Dean A Regier, Brandon Chan, Sarah Costa, David W Scott, Christian Steidl, Joseph M Connors, Aly Karsan, Marco A Marra, Robert Kridel, Ian Cromwell and 1 more

Abstract read
In one paragraph

Article in Cancers, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

11 authors.

Dean A RegierCancer Control Research, BC Cancer, Vancouver, BC V5Z 4C2, Canada.
Brandon ChanCancer Control Research, BC Cancer, Vancouver, BC V5Z 4C2, Canada.
Sarah CostaCancer Control Research, BC Cancer, Vancouver, BC V5Z 4C2, Canada.
David W ScottCentre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z 1L3, Canada.ORCID 0000-0002-0435-5947
Christian SteidlCentre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z 1L3, Canada.
Joseph M ConnorsCentre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z 1L3, Canada.ORCID 0000-0002-1361-7531
Aly KarsanCanada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada.
Marco A MarraCanada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada.
Robert KridelInstitute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada.ORCID 0000-0003-0287-7124
Ian CromwellCancer Control Research, BC Cancer, Vancouver, BC V5Z 4C2, Canada.
Samantha PollardCancer Control Research, BC Cancer, Vancouver, BC V5Z 4C2, Canada.

Funding

Genome Canada 141LYMGenome Canada 271LYM
6 · The paper itself

Abstract

backgroundClassifying diffuse large B-cell lymphoma (DLBCL) into cell-of-origin (COO) subtypes could allow for personalized cancer control. Evidence suggests that subtype-guided treatment may be beneficial in the activated B-cell (ABC) subtype of DLBCL, among patients under the age of 60.

methodsWe estimated the cost-effectiveness of age- and subtype-specific treatment guided by gene expression profiling (GEP). A probabilistic Markov model examined costs and quality-adjusted life-years gained (QALY) accrued to patients under GEP-classified COO treatment over a 10-year time horizon. The model was calibrated to evaluate the adoption of ibrutinib as a first line treatment among patients under 60 years with ABC subtype DLBCL. The primary data source for efficacy was derived from published estimates of the PHOENIX trial. These inputs were supplemented with patient-level, real-world data from BC Cancer, which provides comprehensive cancer services to the population of British Columbia.

resultsWe found the cost-effectiveness of GEP-guided treatment vs. standard care was $77,806 per QALY (24.3% probability of cost-effectiveness at a willingness-to-pay (WTP) of $50,000/QALY; 53.7% probability at a WTP of $100,000/QALY) for first-line treatment. Cost-effectiveness was dependent on assumptions around decision-makers' WTP and the cost of the assay.

conclusionsWe encourage further clinical trials to reduce uncertainty around the implementation of GEP-classified COO personalized treatment in this patient population.

Indexed as

cost-effectiveness analysisdiffuse large b-cell lymphomagene expression profilingmarkov modelmolecular subtyping

Identifiers

PMID35205656
PMCPMC8870002

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Registered trials

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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.