Objective: To assess the cost-effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer.

Methods: An analytical decision model was developed to determine the cost-effectiveness of chemohormonal therapy versus androgen deprivation therapy alone in patients with metastatic hormone-sensitive prostate cancer and patients with non-metastatic high-risk prostate cancer. The cost-effectiveness in metastatic patients with a high-volume disease was assessed separately. The model used data from randomized clinical trials and drug acquisition costs in Brazil. In addition, the costs of post-progression therapies have been included in this model. The benefits to health are expressed as the quality-adjusted life-years, and the incremental cost-effectiveness ratios were calculated.

Results: Chemohormonal therapy may be associated with improved quality-adjusted life-years for all patient. The improvement was more than six times greater for patients with high-volume metastatic disease. In these patients, the incremental cost-effectiveness ratios were up to 74% lower than the incremental cost-effectiveness ratios of patients with non-metastatic disease.

Conclusion: Chemohormonal therapy has been more cost-effective in patients with high-volume metastatic disease.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5823051PMC
http://dx.doi.org/10.1590/S1679-45082017GS4017DOI Listing

Publication Analysis

Top Keywords

chemohormonal therapy
20
therapy patients
12
patients metastatic
12
metastatic hormone-sensitive
12
non-metastatic high-risk
12
high-risk prostate
12
prostate cancer
12
patients high-volume
12
incremental cost-effectiveness
12
cost-effectiveness ratios
12

Similar Publications

The CHAARTED study showed that adding docetaxel (Doc) to androgen deprivation therapy (ADT) in men initiating treatment for metastatic hormone-sensitive prostate cancer (mHSPC) prolongs survival, particularly in high-volume disease. Androgens drive both mHSPC and metastatic castration-resistant prostate cancer (mCRPC). Lower nadir serum testosterone concentrations are associated with better outcomes in men treated with ADT for biochemical relapse, while higher androgens at mCRPC are associated with better prognosis and increased benefit from abiraterone.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to compare the effectiveness and safety of neoadjuvant chemohormonal therapy (NCHT) versus radical prostatectomy (RP) alone in patients with high-risk prostate cancer undergoing robot-assisted surgery.
  • - Data from 1,023 patients were analyzed, with results showing that those who received NCHT had a lower rate of biochemical recurrence (15.8% vs. 29.5%) and better pathology outcomes compared to the RP-only group.
  • - The findings indicate that NCHT could be a beneficial pre-surgery treatment for high-risk prostate cancer, improving outcomes without significant safety concerns, although some adverse events were noted.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the safety and effectiveness of neoadjuvant treatment with degarelix acetate and low-dose estramustine phosphate in men with high-/very high-risk prostate cancer before surgery.
  • A total of 187 patients participated, with 140 undergoing surgery after receiving 6 months of the treatment, highlighting adverse events, surgical outcomes, and rates of biochemical recurrence.
  • Results showed that patients with very high-risk status and those who reduced the dose of estramustine phosphate had lower rates of biochemical recurrence, indicating that maintaining dose compliance may impact survival outcomes in this group.
View Article and Find Full Text PDF

Background And Objective: Prostate cancer (PCa) is the most common cancer in men. High-risk PCa is associated with an increased risk of PCa-related death. The combined use of androgen deprivation therapy (ADT) is essential to improve oncological outcomes in patients with high-risk PCa, and relatively long-term ADT administration is preferred when radiotherapy is performed.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!