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.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5823051 | PMC |
http://dx.doi.org/10.1590/S1679-45082017GS4017 | DOI Listing |
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 PDFInt Urol Nephrol
November 2024
Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagito, Gifu, 501-1194, Japan.
Int J Urol
December 2024
Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan.
Transl Cancer Res
July 2024
Department of Urology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Japan.
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 PDFAdv Oncol
May 2024
Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University School of Medicine, Durham, NC USA.
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