-- Robert Preidt
THURSDAY, Aug. 19 (HealthDay News) -- Use of the drug
trastuzumab in addition to chemotherapy can extend stomach cancer
patients' survival by nearly three months, a new study has
However, an editorial accompanying the study questions whether
the treatment is cost-effective. The study and comment were both
published in the Aug. 19 online edition of
The ToGA study, which included 584 patients at 122 centers in 24
countries with HER2-positive advanced gastric cancer, found that
the addition of trastuzumab to standard cisplatin/fluoropyrimidine
chemotherapy resulted in a median survival of 13.8 months, compared
with 11.1 months for patients who received chemotherapy alone -- a
26 percent difference.
The findings of the phase 3 clinical trial suggest that using
trastuzumab with chemotherapy should be considered a new standard
option for patients with this type of stomach cancer, said Yung-Jue
Bang, of Seoul National University College of Medicine in South
Korea, and colleagues.
But an accompanying editorial by two U.K. experts questions the
cost-effectiveness of the treatment.
"Patients in the ToGA study were treated with trastuzumab every three weeks until disease progression. The median time to progression was 6.7 months," wrote Alastair J. Munro and Dr. Paddy G. Niblock, of the department of surgery and molecular oncology at Ninewells Hospital and Medical School, University of Dundee.
"When we use the cost estimates of trastuzumab therapy calculated by the U.K.'s National Institute for Health and Clinical Excellence (NICE), this equals an average cost of [13,857 British pounds, or US $21,640] per patient. Cost per life-year gained will therefore be around [55,000 British pounds, or US $85,893]," Munro and Niblock continued.
"In the 24 countries that contributed to the study, yearly health expenditure per citizen varies from $40 to $5,500 (2007 U.S. dollars), which reiterates the important moral question -- what is the justification for introducing a treatment that might enable one individual to live a few months longer but, which will consume for each person treated, the total yearly health expenditure for scores of their fellow citizens?" the editorialists wrote.
The American Cancer Society has more about
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