The University of Southampton
University of Southampton Institutional Repository

Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small cell lung cancer: a systematic review

Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small cell lung cancer: a systematic review
Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small cell lung cancer: a systematic review
Background: Lung cancer remains a devastating disease with few effective treatment options. Recent developments in chemotherapy have led to cautious optimism. This paper reviews the evidence on the clinical and cost effectiveness of four of the new generation drugs for patients with lung cancer.
Methods: A systematic review of randomised controlled trials (RCTs) identified from 11 electronic databases (including Medline, Cochrane library and Embase), reference lists and contact with experts and industry was performed to assess clinical effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine. Clinical effectiveness was assessed using the outcomes of patient survival, quality of life, and adverse effects. Cost effectiveness was assessed by development of a costing model and presented as incremental cost per life year saved (LYS) compared with best supportive care (BSC).
Results: Of the 33 RCTs included, five were judged to be of good quality, 10 of adequate quality, and 18 of poor quality. Gemcitabine, paclitaxel, and vinorelbine as first line treatment and docetaxel as second line treatment appear to be more beneficial for non-small cell lung cancer than BSC and older chemotherapy agents, increasing patient survival by 2–4 months against BSC and some comparator regimes. These gains in survival do not appear to be at the expense of quality of life. Survival gains were delivered at reasonable levels of incremental cost effectiveness for vinorelbine, vinorelbine with cisplatin, gemcitabine, gemcitabine with cisplatin, and paclitaxel with cisplatin regimens compared with BSC.
Conclusion: Although the clinical benefits of the new drugs appear relatively small, their benefit to patients with lung cancer appears to be worthwhile and cost effective.
lung cancer, chemotherapy, clinical effectiveness, cost effectiveness
0040-6376
20-28
Clegg, A.
838091f5-39df-4dbe-a369-675b26f2301b
Scott, D.A.
19b5fd34-9974-4ae4-8be0-27a693639e20
Hewitson, P.
8da621e6-874e-4478-8cb7-df98d4052d08
Sidhu, M.
58cb9655-2cd6-4a94-908e-091523528b63
Waugh, N.
4e268891-bf0b-4baa-9933-60257822286c
Clegg, A.
838091f5-39df-4dbe-a369-675b26f2301b
Scott, D.A.
19b5fd34-9974-4ae4-8be0-27a693639e20
Hewitson, P.
8da621e6-874e-4478-8cb7-df98d4052d08
Sidhu, M.
58cb9655-2cd6-4a94-908e-091523528b63
Waugh, N.
4e268891-bf0b-4baa-9933-60257822286c

Clegg, A., Scott, D.A., Hewitson, P., Sidhu, M. and Waugh, N. (2002) Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small cell lung cancer: a systematic review. Thorax, 57 (1), 20-28. (doi:10.1136/thorax.57.1.20).

Record type: Article

Abstract

Background: Lung cancer remains a devastating disease with few effective treatment options. Recent developments in chemotherapy have led to cautious optimism. This paper reviews the evidence on the clinical and cost effectiveness of four of the new generation drugs for patients with lung cancer.
Methods: A systematic review of randomised controlled trials (RCTs) identified from 11 electronic databases (including Medline, Cochrane library and Embase), reference lists and contact with experts and industry was performed to assess clinical effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine. Clinical effectiveness was assessed using the outcomes of patient survival, quality of life, and adverse effects. Cost effectiveness was assessed by development of a costing model and presented as incremental cost per life year saved (LYS) compared with best supportive care (BSC).
Results: Of the 33 RCTs included, five were judged to be of good quality, 10 of adequate quality, and 18 of poor quality. Gemcitabine, paclitaxel, and vinorelbine as first line treatment and docetaxel as second line treatment appear to be more beneficial for non-small cell lung cancer than BSC and older chemotherapy agents, increasing patient survival by 2–4 months against BSC and some comparator regimes. These gains in survival do not appear to be at the expense of quality of life. Survival gains were delivered at reasonable levels of incremental cost effectiveness for vinorelbine, vinorelbine with cisplatin, gemcitabine, gemcitabine with cisplatin, and paclitaxel with cisplatin regimens compared with BSC.
Conclusion: Although the clinical benefits of the new drugs appear relatively small, their benefit to patients with lung cancer appears to be worthwhile and cost effective.

Full text not available from this repository.

More information

Published date: January 2002
Keywords: lung cancer, chemotherapy, clinical effectiveness, cost effectiveness

Identifiers

Local EPrints ID: 40608
URI: http://eprints.soton.ac.uk/id/eprint/40608
ISSN: 0040-6376
PURE UUID: acf39b9f-b223-45fb-b579-bad5ea5e0330
ORCID for D.A. Scott: ORCID iD orcid.org/0000-0001-6475-8046

Catalogue record

Date deposited: 07 Jul 2006
Last modified: 13 Jun 2020 00:47

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×