Aballéa S, Boler A, Craig A, Wasan H
i3 Innovus, Uxbridge, Middlesex, United Kingdom.
Eur J Cancer. 2007 Jul;43(11):1687-93. doi: 10.1016/j.ejca.2007.05.001. Epub 2007 Jun 22.
The MOSAIC study was the first trial to show a statistically significant disease-free survival benefit for a treatment regimen for stage III colon cancer in the adjuvant setting. At 4 years, there was a 25% reduction in the risk of disease recurrence in these patients for the combination of oxaliplatin/5-FU/FA compared with 5-FU/FA alone (p=0.002). This analysis evaluates the long-term cost effectiveness of oxaliplatin given in combination with 5-FU/FA from the perspective of the NHS in the United Kingdom (UK). The cost per quality-adjusted life-year gained over a lifetime was calculated using patient level data from the MOSAIC trial. Trial data were available for a median of 4 years of follow-up, these data were then extrapolated to a lifetime horizon. The estimated incremental lifetime cost per quality-adjusted life-year of oxaliplatin/5-FU/FA compared with 5-FU/FA alone in patients with stage III postoperative colon cancer is pound 4805. This compares favourably with other accepted interventions in oncology.
MOSAIC研究是首个在辅助治疗中显示出针对III期结肠癌治疗方案具有统计学显著无病生存获益的试验。在4年时,与单独使用5-氟尿嘧啶/亚叶酸(5-FU/FA)相比,接受奥沙利铂/5-氟尿嘧啶/亚叶酸联合治疗的这些患者疾病复发风险降低了25%(p = 0.002)。本分析从英国国家医疗服务体系(NHS)的角度评估了奥沙利铂联合5-氟尿嘧啶/亚叶酸的长期成本效益。使用MOSAIC试验的患者层面数据计算了终身获得每质量调整生命年的成本。试验数据的中位随访时间为4年,然后将这些数据外推至终身范围。与单独使用5-氟尿嘧啶/亚叶酸相比,III期术后结肠癌患者使用奥沙利铂/5-氟尿嘧啶/亚叶酸估计的每质量调整生命年的增量终身成本为4805英镑。这与肿瘤学中其他公认的干预措施相比具有优势。