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Q-TWiST analysis of patients receiving temsirolimus or interferon alpha for treatment of advanced renal cell carcinoma.
- Source :
-
PharmacoEconomics [Pharmacoeconomics] 2010; Vol. 28 (7), pp. 577-84. - Publication Year :
- 2010
-
Abstract
- Background and Objectives: For patients with advanced cancers, it is important that treatment improves the quality as well as the quantity of survival. This quality-adjusted time without symptoms of progression or toxicity (Q-TWiST) analysis provides a combined measure of both the overall survival interval and the quality of survival for patients with advanced renal cell carcinoma (RCC) receiving temsirolimus, interferon (IFN)-alpha or the combination of these agents, using data from a phase III clinical trial.<br />Methods: Overall survival was partitioned into three distinct health states: time with serious toxicity (TOX), time after progression (REL) and time without symptoms of progression or toxicity (TWiST). Health states were quality weighted by patient-reported EQ-5D measures collected while receiving treatment.<br />Results: All 626 patients from the trial were included in computation of health-state durations. EQ-5D questionnaires were obtained from 260 patients upon progression and from 230 after a grade 3 or 4 adverse event, and from 278 patients in the TWiST state. Patients receiving temsirolimus had 38% longer TWiST than those receiving IFNalpha (6.5 vs 4.7 months, respectively; p = 0.0005). Patients receiving temsirolimus had 25% longer quality-adjusted survival in terms of Q-TWiST than those receiving IFNalpha (7.0 vs 5.6 months, respectively; p = 0.0015). Differences between the combination (temsirolimus + IFNalpha) and IFNalpha groups were not statistically significant. Threshold utility analysis indicated that temsirolimus was the preferred alternative for all possible utility weights for REL and TOX health states.<br />Conclusion: Temsirolimus resulted in significantly longer Q-TWiST (quality-adjusted survival) in patients with advanced RCC than IFNalpha therapy.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Carcinoma, Renal Cell mortality
Disease-Free Survival
Female
Humans
Interferon Type I administration & dosage
Interferon Type I adverse effects
Interferon Type I therapeutic use
Kidney Neoplasms mortality
Male
Middle Aged
Quality-Adjusted Life Years
Recombinant Proteins
Sirolimus administration & dosage
Sirolimus adverse effects
Sirolimus analogs & derivatives
Sirolimus therapeutic use
Surveys and Questionnaires
Young Adult
Antineoplastic Combined Chemotherapy Protocols adverse effects
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Renal Cell drug therapy
Kidney Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1179-2027
- Volume :
- 28
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- PharmacoEconomics
- Publication Type :
- Academic Journal
- Accession number :
- 20550223
- Full Text :
- https://doi.org/10.2165/11535290-000000000-00000