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Arrieta O, Muñoz-Montaño W, Muñiz-Hernández S, Campos S, Catalán R, Soto-Molina H, Guzmán Vázquez S, Díaz-Álvarez O, Martínez-Pacheco V, Turcott JG, Ramos-Ramírez M, Cabrera-Miranda L, Barrón F, Cardona AF. Efficacy, Safety, and Cost-Minimization Analysis of Continuous Infusion of Low-Dose Gemcitabine Plus Cisplatin in Patients With Unresectable Malignant Pleural Mesothelioma. Front Oncol 2021; 11:641975. [PMID: 33959504 PMCID: PMC8095245 DOI: 10.3389/fonc.2021.641975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/15/2021] [Indexed: 12/29/2022] Open
Abstract
Background Malignant pleural mesothelioma (MPM) is rare and aggressive neoplasia, with a poor prognosis; furthermore, the monetary cost of its treatment represents a major challenge for many patients. The economic burden this malignancy imposes is underscored by the fact that asbestos exposure, which is the most frequent risk factor, is much more prevalent in the lower socioeconomic population of developing countries. The aims of the present study were to evaluate the efficacy, safety, and cost of continuous infusion of low-dose Gemcitabine plus Cisplatin (CIGC) as a treatment strategy for patients with unresectable MPM. Methods We performed a prospective cohort study to determine efficacy and safety of continuous infusion gemcitabine at a dose of 250 mg/m2 in a 6-h continuous infusion plus cisplatin 35 mg/m2 on days 1 and 8 of a 21-day cycle in patients with unresectable MPM. We also performed a cost-minimization analysis to determine if this chemotherapy regimen is less expensive than other currently used regimens. Results The median number of chemotherapy cycles was six (range 1–11 cycles); objective response rate was documented in 46.2%, and disease control rate was seen in 81.2%. Median PFS was 8.05 months (CI 95% 6.97–9.13); median OS was 16.16 months (CI 95% 12.5–19.9). The cost minimization analysis revealed savings of 66.4, 61.9, and 97.7% comparing CIGC with short-infusion gemcitabine plus cisplatin (SIGC), cisplatin plus pemetrexed (CP), and cisplatin plus pemetrexed and bevacizumab (CPB), respectively. Furthermore, this chemotherapy regimen proved to be safe at the administered dosage. Conclusion CIGC is an effective and safe treatment option for patients with unresectable MPM; besides, this combination is a cost-saving option when compared with other frequently used chemotherapy schemes. Therefore, this treatment scheme should be strongly considered for patients with unresectable MPM and limited economic resources.
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Affiliation(s)
- Oscar Arrieta
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.,Thoracic Oncology Unit, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Wendy Muñoz-Montaño
- Thoracic Oncology Unit, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Sae Muñiz-Hernández
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Saul Campos
- Department of Medical Oncology, ISSEMYM, Toluca, Mexico
| | - Rodrigo Catalán
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.,Thoracic Oncology Unit, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | | | | | | | | | - Jenny G Turcott
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Maritza Ramos-Ramírez
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.,Thoracic Oncology Unit, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Luis Cabrera-Miranda
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.,Thoracic Oncology Unit, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Feliciano Barrón
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.,Thoracic Oncology Unit, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Clinical and Translational Oncology Group, Clinica del Country, Bogota, Colombia
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Camps-Herrero C, Paz-Ares L, Codes M, López-López R, Antón-Torres A, Gascón-Vilaplana P, Guillem-Porta V, Carrato A, Cruz-Hernández JJ, Caballero-Díaz C, Blasco-Cordellat A, Moreno-Nogueira JA, Díaz-Rubio E. Social value of a quality-adjusted life year (QALY) in Spain: the point of view of oncologists. Clin Transl Oncol 2014; 16:914-20. [DOI: 10.1007/s12094-014-1170-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 02/19/2014] [Indexed: 11/25/2022]
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Borràs J, Espinàs J, Ferro T, de la Puente M, Cordón F, Argimon J. Impacto del cáncer en Cataluña: consecuencias para las prioridades en prevención, diagnóstico y tratamiento. Med Clin (Barc) 2008; 131 Suppl 1:42-9. [DOI: 10.1016/s0025-7753(08)76432-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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