Drug Appears to Prolong Survival in Stomach Cancer Patients
But experts question whether high cost of treatment can be justified
THURSDAY, Aug. 19, 2010 (HealthDay News) -- Use of the drug trastuzumab in addition to chemotherapy can extend stomach cancer patients' survival by nearly three months, a new study has found.
However, an editorial accompanying the study questions whether the treatment is cost-effective. The study and comment were both published in the Aug. 19 online edition of The Lancet.
The ToGA study, which included 584 patients at 122 centers in 24 countries with HER2-positive advanced gastric cancer, found that the addition of trastuzumab to standard cisplatin/fluoropyrimidine chemotherapy resulted in a median survival of 13.8 months, compared with 11.1 months for patients who received chemotherapy alone -- a 26 percent difference.
The findings of the phase 3 clinical trial suggest that using trastuzumab with chemotherapy should be considered a new standard option for patients with this type of stomach cancer, said Yung-Jue Bang, of Seoul National University College of Medicine in South Korea, and colleagues.
But an accompanying editorial by two U.K. experts questions the cost-effectiveness of the treatment.
"Patients in the ToGA study were treated with trastuzumab every three weeks until disease progression. The median time to progression was 6.7 months," wrote Alastair J. Munro and Dr. Paddy G. Niblock, of the department of surgery and molecular oncology at Ninewells Hospital and Medical School, University of Dundee.
"When we use the cost estimates of trastuzumab therapy calculated by the U.K.'s National Institute for Health and Clinical Excellence (NICE), this equals an average cost of [13,857 British pounds, or US $21,640] per patient. Cost per life-year gained will therefore be around [55,000 British pounds, or US $85,893]," Munro and Niblock continued.
"In the 24 countries that contributed to the study, yearly health expenditure per citizen varies from $40 to $5,500 (2007 U.S. dollars), which reiterates the important moral question -- what is the justification for introducing a treatment that might enable one individual to live a few months longer but, which will consume for each person treated, the total yearly health expenditure for scores of their fellow citizens?" the editorialists wrote.
The American Cancer Society has more about stomach cancer.