P1-10-05: Is the 21-Gene Breast Cancer Test (Oncotype DX®) Cost-Effective?
Notice bibliographique
Résumé
Abstract Background: The Oncotype DX® Breast Cancer Test is a validated 21-gene assay that predicts 10 year risk of recurrence and the likelihood of benefit from adjuvant chemotherapy in early-stage, node-negative ER+ breast cancer. The cost-effectiveness of using Oncotype DX® has been published in several countries but to date, there hasn't been any review of these studies. Materials and methods: The electronic database Pubmed and a selection of congress databases were searched using combinations of search terms designed to identify publications describing cost-effectiveness analyses of Oncotype DX®in early stage breast cancer patients. Searches were limited to those published in the English language between January 2001 and April 2011. All records were screened for inclusion in the review. The methodological quality of selected publications was assessed using the 35 items methodological checklist from Drummond et al (1996). Results: Five published health economics analyses and 3 abstracts (two posters and an oral presentation) were identified. The studies were carried out in several countries (US (2), Canada (2), Japan, Israel, Singapore and Hungary and have used a Markov modelling approach based on data from a large multicentre trial (e.g. NSABP B-20) to make estimates of long-term outcomes, and assess the cost-effectiveness of using the Oncotype DX® recurrence score in patients classified as having a high or low risk of distant recurrence using other methods of assessment. All studies were carried out in the perspective of the healthcare payer, and therefore did not consider broader costs to the patients and the society. Study comparators, costs, characteristics of the population receiving the test and impact of using the Oncotype DX® results on treatment decisions were adapted to each individual country clinical practice explaining the large range of cost-effectiveness results from these studies. In the US, using Oncotype DX® was shown to be cost-saving when in one of the Canadian studies, it was likely to be cost-effective (incremental cost-effectiveness ratio of $64,063 per QALY gained). Consistently across all five studies, use of Oncotype DX® was projected to improve survival (where reported), quality-adjusted life expectancy and to reduce chemotherapy costs versus comparators. When looking at the methodological quality of studies, they generally scored well with positive responses to 24 or more of the 35 questions on reporting. The exception was the Lyman et al. (US) paper where only 17 positive responses were recorded. The two posters, as expected scored lower than the full scale articles with positive responses of 15 and 18 out of 35 items. Conclusions: Published literature to date is of good methodological quality and consistently supports the cost-effectiveness of using Oncotype DX® in the various settings. Further analyses should be carried on to assess the budget impact of funding Oncotype DX® and to include a broader perspective of the costs. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-10-05.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,029 | 0,150 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,010 |
| Bibliométrie | 0,004 | 0,005 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,005 | 0,003 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,004 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».