In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. 2032-2032
Abstract:
2032 Background: Routine clinical use of bevacizumab (Bev) in recurrent glioblastoma (rGBM) is controversial, as no large RCT has shown a survival advantage. We describe treatment algorithms, survival (OS), quality-adjusted survival (QAS) as well as costs of patients (pts) with GBM treated at an academic hospital in Switzerland, where Bev is registered and reimbursed for rGBM. Methods: Pts’ and treatment characteristics from diagnosis until death (including neurological symptoms and toxicities) of all pts over a 5-year period were retrospectively retrieved from our GBM database. For each treatment period (1 st -line, recurrence and “best supportive care”) time to next treatment (TNT), OS and QAS were calculated and modelled for prognostic factors (Cox regression). QAS was evaluated as previously described (Murray et al). In- and out-patient costs were calculated from time of diagnosis until death in respect of Bev treatment (+Bev vs. –Bev). Results: 82 newly diagnosed GBM pts with a median age of 66 years (range 39-85), median KPS of 90% (range 50-100%), who were treated with 1 (n = 75), 2 (n = 36) or 3 (n = 14) lines of therapy, respectively, lived for a median OS of 11.9 (SD 9.7) months (mos). QAS was 5.3 (SD 6.9) mos i.e. 44% of the numerical survival time. 40% of patients were treated with Bev at 1 st or 2 nd recurrence. Pts, who were selected for BEV treatment, had a longer time from diagnosis to 2 nd line treatment (median 5.2 (SD 6.3) mos) as compared to pts in the -Bev group (median 2.1 (SD 1.8) mos). Younger age and Bev treatment were associated with longer OS and QAS. QAS to OS ratio was 52% (9.4 out of 18.1 mos) for BEV treated patients and 34% (2.8 out of 8.2 mos) for the –Bev group, respectively. Bev treatment increased the overall treatment costs by 1.7x. The population adjusted incremental cost-effectiveness ratio (ICER) was CHF 75,669 per life year gained. Conclusions: QAS in patients with GBM is short (one third to half of OS). In our cohort, pts selected for Bev treatment had longer OS and longer QAS - at costs below the accepted threshold of 100,000 CHF per life year gained. Whether this gain of lifetime is a direct result of Bev treatment or a consequence of a selection bias needs to be addressed prospectively.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.15_suppl.2032
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
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