Evaluation du cout et de l'éfficacité des thérapies ciblées dans le traitement des cancers colorectaux métastatiques

الموضوعات

طب

الملخص

La lutte contre le cancer colorectal metastatique (CCRM) a progresse ces dernieres annees, grace a l fadjonction a la chimiotherapie, des therapies ciblees contre les facteurs de l fangiogenese (bevacizumab) ou les recepteurs de facteurs de croissance tumorale (cetuximab et panitumumab). Si ces therapies ciblees ont fait la preuve de leur efficacite sur la SG et la SSP, elles restent neanmoins des molecules onereuses; leur cout important nous a incite a realiser une etude medico-economique de type cout .efficacite. Objectifs : Ce travail a pour objectif d fevaluer le cout de ces traitements en 1ere ligne chez les patients atteints de CCRM, leur efficacite et d fetablir le ratio incremental cout-efficacite ICER. Patients et methodes : Une etude descriptive medico-economique de type cout-efficacite, observationnelle prospective a ete realisee au service d foncologie medicale du CAC de Blida entre juillet 2016 et decembre 2018. Les patients inclus etaient tous atteints d fun CCRM avec statut de performance . 02, statut RAS disponible et recevant un traitement de 1ere ligne associant une molecule de therapie ciblee + chimiotherapie. Resultats : 87 patients repondant aux criteres d finclusion etaient inclus dans l fetude : 49 patients avec statut RAS mute ont recu le protocole bevacizumab-FOLFOX4 , la moyenne de cures etait de 11 cures avec des extremes de 06 et 20 cures, le % de RO etait de 48.9%, le % de controle tumoral etait de73.4%, le % de progression etait de 26.5%, le protocole etait globalement bien tolere sans alteration de la qualite de vie, les medianes de SSP et de SG etaient respectivement de 10 et 19 mois, le cout medical direct/cure etait de 152591.69DA, la mediane du cout de la 1ere ligne etait de 1831100DA avec des extremes de 915550 et 3051820DA, le ratio ICER etait de 1597908DA/0.23 annee de vie gagnee. 38 patients avec statut RAS non mute (sauvage) ont recu le protocole cetuximab-FOLFIRI, la moyenne de cures etait de 10.2 cures avec des extremes de 06 et 21 cures, le % de RO etait de 52.6%, le % de controle tumoral etait de71%, le % de progression etait de 28.9%, le protocole etait globalement bien tolere mais ayant altere de facon transitoire la qualite de vie de certains patients, les medianes de SSP et de SG etaient respectivement de 09 et 19 mois, le cout medical direct/cure etait de 317407.31DA, la mediane du cout de la 1ere ligne etait de 3808887DA avec des extremes de 1904443 et 6665547DA, le ratio ICER etait de 3539313DA/0.13 annee de vie gagnee. Conclusion : L futilisation des therapies ciblees dans le traitement du CCRM a genere des couts importants au prix d fun allongement de la survie de quelques mois, par manque de donnees sur le seuil d facceptabilite en Algerie concernant les molecules onereuses, il nous a ete difficile d fetablir une conclusion sur le resultat ICER trouve.

روابط وملفات

التعريف والنوع

رقم الوثيقة

09b746a6-b2d0-473d-94b8-38774502eebd

رقم العقد

0

نوع الوسائط

Crawler

نوع المحتوى

الرسائل العلمية

صيغة المصدر

رسائل دكتوراة

نوع الملف

pdf text

أسماء الملفات

2225251_1.pdf

بيانات النشر

ألقاب المؤلفين

[{"name_ar":" Farida Smaili","title_ar":"اشراف","title_en":"Supervision"},{"name_ar":" Souad Bekouaci","title_ar":"اعداد","title_en":"Preparation"}]

اللغة

French

المصدر والدورية

اسم المصدر

Evaluation du cout et de l'éfficacité des thérapies ciblées dans le traitement des cancers colorectaux métastatiques

المحتوى والصفحات

عدد الصفحات

0

ترجمة الملخص

Introduction: The fight against metastatic colorectal cancer (CCRM) has progressed in recent years, thanks to the addition to chemotherapy, targeted therapies against angiogenesis factors (bevacizumab) or tumor growth factor receptors (cetuximab and panitumumab). If these targeted therapies have proven their effectiveness on SG and PFS, they are nevertheless expensive molecules; their high cost prompted us to carry out a cost-effectiveness medico-economic study. Objectives: The objective of this work is to evaluate the cost of these first-line treatments in patients with CCRM, their effectiveness and to establish the ICER incremental cost-effectiveness ratio. Patients and methods: A cost-effectiveness, prospective observational, medico-economic descriptive study was carried out at the medical oncology department of the CAC de Blida between July 2016 and December 2018. The patients included all had CCRM with status. performance ≤ 02, RAS status available and receiving first-line treatment combining a targeted therapy molecule + chemotherapy.Results:87 patients meeting the inclusion criteria were included in the study: 49 patients with mutated RAS status received the bevacizumab-FOLFOX4 protocol, the average of cures was 11 cures with extremes of 06 and 20 cures, the% of OR was 48.9%,% of tumor control was 73.4%,% of progression was 26.5%, the protocol was overall well tolerated with no deterioration in quality of life, the medians of PFS and OS were respectively from 10 and 19 months, the direct medical cost / cure was 152,591.69DA, the median of the cost of the 1st line was 1,831,100DA with extremes of 915,550 and 3051820DA, the ICER ratio was 1597,908DA /0.23 years of life gained. 38 patients with non-mutated (wild-type) RAS status received the cetuximab-FOLFIRI protocol, the mean of cures was 10.2cures with extremes of 06 and 21 cures, the% of OR was 52.6%, the% of tumor control was of 71%, the% of progression was 28.9%, the protocol was overall well tolerated but having transiently impaired the quality of life of some patients, the medians of PFSand OS were respectively 09 and 19 months, the medical cost direct / cure was 317407.31DA, the median of the cost of the 1st line was 3808887DA with extremes of 1904443 and 6665547DA, the ICER ratio was 3539313DA / 0.13 years of life gained. Conclusion:The use of targeted therapies in the treatment of CCRM has generated significant costs at the cost of prolonging survival by a few months, due to the lack of data on the threshold of acceptability in Algeria concerning expensive molecules, we was difficult to draw a conclusion on the ICER result found.

كلمات الباحثين

Système de santé Thérapie ciblée

إشراف وإعداد

الإشراف

Farida Smaili

الإعداد

Souad Bekouaci

الاقتباسات الببليوغرافية