上皮性卵巢癌(EOC)的多腺苷核糖磷酸抑制剂(PARPi)一级与二级维持治疗的过度治疗和成本效益。

Gynecology & obstetrics (Sunnyvale, Calif.) Pub Date : 2021-01-01 Epub Date: 2021-10-07
Peter G Rose, Meng Yao, Laura M Chambers, Lin Mei, Phuc Le
{"title":"上皮性卵巢癌(EOC)的多腺苷核糖磷酸抑制剂(PARPi)一级与二级维持治疗的过度治疗和成本效益。","authors":"Peter G Rose,&nbsp;Meng Yao,&nbsp;Laura M Chambers,&nbsp;Lin Mei,&nbsp;Phuc Le","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>No data exist to suggest PARP inhibitor (PARPi) therapy as first-line maintenance is superior to PARPi therapy as second-line maintenance.</p><p><strong>Objective: </strong>To determine the efficacy and cost of primary versus secondary olaparib or niraparib maintenance in Epithelial Ovarian Cancer (EOC).</p><p><strong>Methods: </strong>A retrospective cohort study was performed in women with EOC to determine the survival following primary or secondary PARPi maintenance. We modeled the costs of olaparib and niraparib based on previously published costs and duration of therapy based on the Solo 1/Solo 2 and Prima and Nova trials, respectively.</p><p><strong>Results: </strong>Among 40 patients treated with PARPi as primary or secondary maintenance there was no difference in overall survival (p=0.97). Among 166 women with stage III/IV germ-line BRCA mutated EOC, 28.8% were disease free for >3 years (18.6% never recurred and 10.2% recurred >3 years after chemotherapy). Since 29% of the BRCA mutated patients did not recur within 3 years, primary olaparib maintenance therapy was significantly more expensive than secondary olaparib maintenance therapy by 260%. Primary niraparib maintenance therapy was slightly more expensive than secondary niraparib maintenance therapy by 4%, 51%, and 15% for BRCA mutated, HR deficient, and HR proficient patients, respectively. By eliminating the overtreatment of patients with primary PARPi therapy, the cost savings for 100 women with EOC with BRCA mutations would be $37,335,360 for olaparib and $8,197,592 for niraparib.</p><p><strong>Conclusion: </strong>Up to 29% of BRCA mutated patients may be overtreated with primary PARPi maintenance with significantly increased treatment costs.</p>","PeriodicalId":89928,"journal":{"name":"Gynecology & obstetrics (Sunnyvale, Calif.)","volume":"11 9","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8681231/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Overtreatment and Cost Effectiveness of Primary <i>versus</i> Secondary Maintenance Therapy with Poly-Adenosine Ribose Phosphate Inhibitors (PARPi) for Epithelial Ovarian Cancer (EOC).\",\"authors\":\"Peter G Rose,&nbsp;Meng Yao,&nbsp;Laura M Chambers,&nbsp;Lin Mei,&nbsp;Phuc Le\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>No data exist to suggest PARP inhibitor (PARPi) therapy as first-line maintenance is superior to PARPi therapy as second-line maintenance.</p><p><strong>Objective: </strong>To determine the efficacy and cost of primary versus secondary olaparib or niraparib maintenance in Epithelial Ovarian Cancer (EOC).</p><p><strong>Methods: </strong>A retrospective cohort study was performed in women with EOC to determine the survival following primary or secondary PARPi maintenance. We modeled the costs of olaparib and niraparib based on previously published costs and duration of therapy based on the Solo 1/Solo 2 and Prima and Nova trials, respectively.</p><p><strong>Results: </strong>Among 40 patients treated with PARPi as primary or secondary maintenance there was no difference in overall survival (p=0.97). Among 166 women with stage III/IV germ-line BRCA mutated EOC, 28.8% were disease free for >3 years (18.6% never recurred and 10.2% recurred >3 years after chemotherapy). Since 29% of the BRCA mutated patients did not recur within 3 years, primary olaparib maintenance therapy was significantly more expensive than secondary olaparib maintenance therapy by 260%. Primary niraparib maintenance therapy was slightly more expensive than secondary niraparib maintenance therapy by 4%, 51%, and 15% for BRCA mutated, HR deficient, and HR proficient patients, respectively. By eliminating the overtreatment of patients with primary PARPi therapy, the cost savings for 100 women with EOC with BRCA mutations would be $37,335,360 for olaparib and $8,197,592 for niraparib.</p><p><strong>Conclusion: </strong>Up to 29% of BRCA mutated patients may be overtreated with primary PARPi maintenance with significantly increased treatment costs.</p>\",\"PeriodicalId\":89928,\"journal\":{\"name\":\"Gynecology & obstetrics (Sunnyvale, Calif.)\",\"volume\":\"11 9\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8681231/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gynecology & obstetrics (Sunnyvale, Calif.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/10/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gynecology & obstetrics (Sunnyvale, Calif.)","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/10/7 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:没有数据表明PARP抑制剂(PARPi)治疗作为一线维持优于PARPi治疗作为二线维持。目的:确定原发性和继发性奥拉帕尼或尼拉帕尼维持治疗上皮性卵巢癌(EOC)的疗效和成本。方法:对EOC女性患者进行回顾性队列研究,以确定原发性或继发性PARPi维持后的生存率。我们分别基于先前发表的基于Solo 1/Solo 2和Prima和Nova试验的成本和治疗持续时间对olaparib和niraparib的成本进行了建模。结果:在40例以PARPi作为主要或次要维持治疗的患者中,总生存期无差异(p=0.97)。在166名III/IV期生殖系BRCA突变EOC的女性中,28.8%的患者在化疗后3年以上无疾病(18.6%从未复发,10.2%在化疗后3年以上复发)。由于29%的BRCA突变患者在3年内没有复发,因此初级奥拉帕尼维持治疗的费用明显高于二级奥拉帕尼维持治疗的260%。BRCA突变、HR缺陷和HR熟练患者的初级尼拉帕尼维持治疗分别比次级尼拉帕尼维持治疗贵4%、51%和15%。通过消除原发性PARPi治疗患者的过度治疗,100名携带BRCA突变的EOC女性患者使用奥拉帕尼可节省37,335,360美元,使用尼拉帕尼可节省8,197,592美元。结论:高达29%的BRCA突变患者可能会过度接受初级PARPi维持治疗,从而显著增加治疗费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
The Overtreatment and Cost Effectiveness of Primary versus Secondary Maintenance Therapy with Poly-Adenosine Ribose Phosphate Inhibitors (PARPi) for Epithelial Ovarian Cancer (EOC).

Background: No data exist to suggest PARP inhibitor (PARPi) therapy as first-line maintenance is superior to PARPi therapy as second-line maintenance.

Objective: To determine the efficacy and cost of primary versus secondary olaparib or niraparib maintenance in Epithelial Ovarian Cancer (EOC).

Methods: A retrospective cohort study was performed in women with EOC to determine the survival following primary or secondary PARPi maintenance. We modeled the costs of olaparib and niraparib based on previously published costs and duration of therapy based on the Solo 1/Solo 2 and Prima and Nova trials, respectively.

Results: Among 40 patients treated with PARPi as primary or secondary maintenance there was no difference in overall survival (p=0.97). Among 166 women with stage III/IV germ-line BRCA mutated EOC, 28.8% were disease free for >3 years (18.6% never recurred and 10.2% recurred >3 years after chemotherapy). Since 29% of the BRCA mutated patients did not recur within 3 years, primary olaparib maintenance therapy was significantly more expensive than secondary olaparib maintenance therapy by 260%. Primary niraparib maintenance therapy was slightly more expensive than secondary niraparib maintenance therapy by 4%, 51%, and 15% for BRCA mutated, HR deficient, and HR proficient patients, respectively. By eliminating the overtreatment of patients with primary PARPi therapy, the cost savings for 100 women with EOC with BRCA mutations would be $37,335,360 for olaparib and $8,197,592 for niraparib.

Conclusion: Up to 29% of BRCA mutated patients may be overtreated with primary PARPi maintenance with significantly increased treatment costs.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
To PARPI or Not to PARPI BRCA Mutated Ovarian Cancer Following First-line Chemotherapy, That is the Question? The Overtreatment and Cost Effectiveness of Primary versus Secondary Maintenance Therapy with Poly-Adenosine Ribose Phosphate Inhibitors (PARPi) for Epithelial Ovarian Cancer (EOC). Chemotherapy for Elderly Ovarian Cancer Patients Exosomes in Plasma of Patients with Ovarian Carcinoma: Potential Biomarkers of Tumor Progression and Response to Therapy. Maternal Hypothyroidism and Pregnancy Loss: Awaiting Firm Recommendations on Testing and Treatment.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1