Re: cancer drug warrants healthy skepticism

[X-posting snipped]
"Jim Chinnis" <jchinnis@xxxxxxxxxxxxxxxx> wrote in message
news:7cb0k197ks7eu2noukv6q7sj4jud12ev9f@xxxxxxxxxx
> "fresh~horses" <fresh~horses@xxxxxxxxxxxxx> wrote in part:
>
> >Cancer drug warrants healthy skepticism
> >by Alan Cassels
> >
> >As this is my inaugural column in Common Ground, I would like readers
> >to know that I am keenly, almost pathologically, interested in the
> >quality of information people receive about health and drug treatments.
> >I'll draw on my voracious appetite for pharmaco-journalism, and use
> >this space to deconstruct some of the prevailing mythology
>
> Actually, there have been a number of skeptical papers in the medical
> journals. I think the journalists should bear much of the blame for the
> "mythology" in the case of Herceptin (trastuzumab).
>
> For instance:
>
> Ann Oncol. 2005 Jun;16(6):909-14. Epub 2005 Apr 22. Related Articles,
Links
>
> A monoclonal antibody against HER-2 (trastuzumab) for metastatic breast
> cancer: a model-based cost-effectiveness analysis.
>
> Norum J, Risberg T, Olsen JA.
>
> Department of Oncology, University Hospital of North Norway, Tromso,
Norway.
> jan.norum@xxxxxx
>
> BACKGROUND: The aim of this study was to evaluate the cost-effectiveness
of
> trastuzumab in patients with metastatic breast cancer (MBC) in a
model-based
> cost-effectiveness analysis (CEA). Trastuzumab has shown considerable
> activity in patients with MBC that overexpress HER2. However, significant
> resources have been allocated to finance this new therapy. Due to ever
> increasing pressures on health care budgets, economic evaluations are
> requested in order to compare health effects with costs. METHODS: All
> available data on trastuzumab in MBC presented at the San Antonio breast
> cancer conference in late 2003 and all data on Medline in December 2003
were
> analysed for life years (LY) gained and quality of life (QoL) with regard
to
> the use of this new monoclonal antibody. Randomised studies comparing
> standard chemotherapy, with or without trastuzumab, were focused. The
costs
> were calculated according to Norwegian prices as of January 2003. RESULTS:
> The LY gained ranged between 0.3 and 0.7 years. The median cost per
patient
> treated was 44 196 yielding costs per life year saved in the range 63
> 137-162 417 depending on survival gain and discount rate employed. A
> sensitivity analysis documented the price of trastuzumab and the survival
> benefit the two major factors influencing the cost-effectiveness ratio.
> CONCLUSION: The economic evaluation indicates that trastuzumab is not cost
> effective in metastatic breast cancer. Reduced drug costs and/or improved
> survival may alter the conclusion.
> --
> Jim Chinnis Warrenton, Virginia, USA
----------
But were the women who were treated with it all "appropriate candidates" for
it? If you give Herceptin to someone who doesn't have exactly the right
kind of cancer to benefit from it, they won't. I think that since 2003 more
has been learned about who falls into that small set of patients who will
benefit greatly from Herceptin...and I, of course, HER2+++, hope that means
me.

Eva


.

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