PMID- 31303965
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200225
IS  - 1949-2553 (Electronic)
IS  - 1949-2553 (Linking)
VI  - 10
IP  - 42
DP  - 2019 Jul 2
TI  - Contribution of trastuzumab to the prognostic improvement of HER2-positive early 
      breast cancer in Spain: an estimation of life years and disease-free life years 
      gained since its approval.
PG  - 4321-4332
LID - 10.18632/oncotarget.27039 [doi]
AB  - INTRODUCTION: Trastuzumab has become the standard treatment for both 
      HER2-positive early and metastatic breast cancer (HER2+ eBC or mBC) since its 
      approval. The objective of the study is to estimate the benefit of adjuvant 
      trastuzumab in the treatment of patients with HER2+ eBC in terms of life years 
      gained (LYG) and disease-free life years gained (DFLYG) since its approval in 
      Spain in 2006. RESULTS: 35,851 women make up the cohorts from 2006 to 2017. In 
      the T (trastuzumab)+CT (chemotherapy) scenario, the sum of life years was 605,358 
      (525,964 disease-free) versus 564,137 (489,916 disease-free) in the CT scenario, 
      resulting in 41,221 LYG (36,048 disease-free) due to trastuzumab. The general 
      population for the same age range would have generated 704,331 LY. The estimated 
      incremental cost was 880.43 millioneuro (euro24,558.13 per patient) from 2006 to 2035. 
      The incremental cost-effectiveness ratios obtained were euro20,644 and euro23,960 per 
      LYG and DFLYG, respectively. METHODS: An epidemiological model was developed with 
      a time horizon until 2035 and a 3% discount rate. The model compared two 
      scenarios, with and without trastuzumab as adjuvant therapy. The effectiveness 
      data to model the survival curves were obtained from BCIRG 006 study and direct 
      costs were included. CONCLUSIONS: Adjuvant trastuzumab has substantially improved 
      the survival of patients with HER2+ eBC, contributing over 41,000 LYG to Spanish 
      society (over 36,000 DFLYG) in a cost-effective manner. However, the sum of LYG 
      with trastuzumab is still far from the LY estimated for the general population, 
      supporting the need of further advances in HER2+ eBC.
FAU - Ciruelos, Eva
AU  - Ciruelos E
AD  - Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, 
      Spain.
FAU - Alba, Emilio
AU  - Alba E
AD  - Clinical Oncology Unit, Hospitales Universitarios Regional y Virgen de la 
      Victoria; Instituto de Investigacion Biomedica de Malaga (IBIMA), Malaga, Spain.
FAU - Lopez, Rafael
AU  - Lopez R
AD  - Department of Medical Oncology, Hospital Clinico Universitario e Instituto de 
      Investigacion Sanitaria-CIBERONC, Santiago de Compostela, Spain.
FAU - Lluch, Anna
AU  - Lluch A
AD  - Department of Medical Oncology, Hospital Clinico Universitario de Valencia, 
      Health Research Institute INCLIVA, University of Valencia, The Centre of 
      Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain.
FAU - Martin, Miguel
AU  - Martin M
AD  - Medical Oncology Service, Instituto de Investigacion Sanitaria Gregorio Maranon, 
      Universidad Complutense, GEICAM, CIBERONC, Madrid, Spain.
FAU - Arroyo, Isabel
AU  - Arroyo I
AD  - Department of Payer Evidence and Health Economics, Roche Pharma, Madrid, Spain.
FAU - Navarro, Beatriz
AU  - Navarro B
AD  - Medical Department, Roche Pharma, Madrid, Spain.
FAU - Carcedo, David
AU  - Carcedo D
AD  - Oblikue Consulting, Barcelona, Spain.
FAU - Colomer, Ramon
AU  - Colomer R
AD  - Medical Oncology Service, Hospital Universitario La Princesa, Madrid, Spain.
FAU - Albanell, Joan
AU  - Albanell J
AD  - Medical Oncology Service, Hospital del Mar, IMIM, Universitat Pompeu Fabra, The 
      Centre of Networked Biomedical Cancer Research (CIBERONC), and Centro Oncologico 
      Clara Campal-HM Delfos, Barcelona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20190702
PL  - United States
TA  - Oncotarget
JT  - Oncotarget
JID - 101532965
PMC - PMC6611514
OTO - NOTNLM
OT  - Spain
OT  - early breast cancer
OT  - economics
OT  - life-years
OT  - trastuzumab
COIS- CONFLICTS OF INTEREST Dra. Eva Ciruelos has received honoraria for participation 
      in Advisory Boards and Speakers Bureau from Novartis, Pfizer, Lilly and Roche. 
      Dr. Emilio Alba has received honoraria for participation in Advisory Boards from 
      Roche, Novartis, Pfizer and Lilly, and research grants from Roche and Sysmex. Dr. 
      Rafael Lopez has received honoraria for participation in Advisory Boards from 
      Roche, AstraZeneca, Merck, MSD, Bayer, BMS, Novartis, Janssen, Lilly, Pfizer and 
      Leo; travel, accommodations and expenses from Pharmamar, Roche, BMS and Pierre 
      Fabre; research funding from Roche and Merck; and is co-founder and shareholder 
      in Nasasbiotech, S.L., Mtrap Inc. Dra. Ana Lluch has received research funding 
      (paid to INCLIVA) from Amgen, Astra Zeneca, Boehringer-Ingelheim, GSK, Novartis, 
      Pfizer, Roche/Genentech, Eisai, Celgene and Pierre Fabre; and honoraria for 
      participation in Advisory Boards and Consulting from Novartis, Pfizer, 
      Roche/Genentech, Eisai, Celgene. Dr. Miguel Martin has received speaker's 
      honoraria from Pfizer and Lilly, honoraria for participation in Advisory Boards 
      from AstraZeneca, Novartis, Roche-Genentech, Pfizer, Glaxo, Pharmamar, Taiho 
      Oncology and Lilly, and research grants from Novartis and Roche. Arroyo I and 
      Navarro B are employees of Roche which is the developer of the studio. Carcedo D 
      works for the consultancy Oblikue Consulting, who received a grant from Roche for 
      the realization of the study. Dr. Ramon Colomer has received speaker's honoraria 
      from BMS, Pfizer, MSD, Janssen and Novartis, honoraria for participation as 
      consultant or in Advisory Boards from Lilly, MSD, Roche and Servier, research 
      funding from BMS, MSD, Roche, Pfizer, Astrazeneca and Astellas, and has 
      participated in other activities from Instituto Roche, Sanofi and Pfizer. Dr. 
      Joan Albanell has participated in advisory boards and industry sponsored meeting 
      by Roche, Pfizer, Amgen and Novartis.
EDAT- 2019/07/16 06:00
MHDA- 2019/07/16 06:01
PMCR- 2019/07/02
CRDT- 2019/07/16 06:00
PHST- 2019/02/12 00:00 [received]
PHST- 2019/06/05 00:00 [accepted]
PHST- 2019/07/16 06:00 [entrez]
PHST- 2019/07/16 06:00 [pubmed]
PHST- 2019/07/16 06:01 [medline]
PHST- 2019/07/02 00:00 [pmc-release]
AID - 27039 [pii]
AID - 10.18632/oncotarget.27039 [doi]
PST - epublish
SO  - Oncotarget. 2019 Jul 2;10(42):4321-4332. doi: 10.18632/oncotarget.27039. 
      eCollection 2019 Jul 2.