Research News
Stanford study finds Herceptin® is cost-effective after surgery for early breast cancer
 |
|
|
|
Allison W. Kurian, MD, MSc |
Trastuzumab (Herceptin) is cost effective when used after surgery for early HER2-positive breast cancer, Stanford study finds
The drug trastuzumab (Herceptin), used in combination with standard chemotherapy following surgery for early-stage HER2-positive cancer, is cost effective, despite the high price of the drug, according to researchers at the Stanford Cancer Center.
Trastuzumab has been used as a treatment for advanced breast cancer since 1998, and in 2005 was shown to increase survival in women with early-stage breast cancer.
Adjuvant trastuzumab costs $50,000 to $65,000 for a one-year course of treatment.
The Stanford study, as well as a separate, related study, from Italy, on the cost effectiveness of trastuzamab recently were published in the online version of the Journal of Clinical Oncology (JCO).
Stanford’s findings
The Stanford study, led by Allison W. Kurian, MD, MSc, Instructor in Medicine (Oncology), looked at the costs and health benefits of chemotherapy regimens alone and with trastuzumab for patients with early breast cancer. Therapy consisted of adjuvant trastuzumab used in combination with the anthracycline-based or non-anthracycline-based chemotherapy regimens tested to date in clinical trials of adjuvant trastuzamab in early breast cancer.
Results of the study showed that the costs per life-year saved (a standard measure of cost effectiveness) of adjuvant trastuzumab with doxorubicin plus cyclophosphamide followed by paclitaxel were almost $40,000. This cost is still comparable to or less than that of widely accepted therapies, including treatments for early-stage breast cancer. However, the Stanford research team found that trastuzumab combined with chemotherapy regimens that used docetaxel and carboplatin were not as cost effective, based on the relatively short follow-up available from clinical trials.
“Some people may be surprised by this result,” said Dr. Kurian. “Our findings show that in a specific treatment situation – early in the course of the disease – even an expensive therapy like trastuzumab can provide enough health benefits that it represent a good value.”
Results from Italian study
The Italian study compared the long-term cost and effectiveness of trastuzumab with chemotherapy (using doxorubicin plus cyclophosphamide) versus chemotherapy alone for patients with early-stage HER2-positive breast cancer. The study estimated that trastuzumab improves 15-year survival without any signs of cancer from 39 percent to 52 percent and 15-year overall survival from 44 percent to 58 percent and prevents one relapse in six treated patients.
The Italian researchers found that the cost per life-year saved with this therapy is approximately $19,000, which is comparable to that of similar treatments of early breast cancer. Adjuvant chemotherapy alone for women over 65 years with lymph node-positive breast cancer costs $43,000 per life-year saved and axillary lymph node dissection in post-menopausal women with estrogen receptor-positive breast cancer costs $36,000 per life-year saved.
Implications of findings for patients
Finding from the two studies come at a time of growing debate over the high cost of new targeted therapies. Trastuzumab is expensive, but it appears to offer value comparable to that of other well-accepted treatments when used as ajuvant therapy for women with early HER2-positive breast cancer. These findings could have implications for patients whose health care coverage does not currently cover trastuzumab therapy.
Posted: 3/30/07
Trial Administration