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- W4288052129 abstract "Abstract Objective : The aims of this study was to appraise the health economic evidence for adjuvant chemotherapy (AC) strategies in stage II and III colorectal cancer (CRC) and to identify gaps in the available evidence that might inform further research. Method : A systematic review of published economic evaluations was undertaken. Four databases were searched and full-text publications in English were screened for inclusion. A narrative synthesis was performed to summarise the evidence. Results : Thirty-eight studies were identified and stratified by cancer stage and AC strategy. The majority (89%) were full economic evaluations considering both health outcomes, usually measured as quality-adjusted life years (QALYs), and costs. AC was found to be cost-effective compared to no AC for both stage II and III CRC. Oral and oxaliplatin-based AC was cost-effective for stage III. Three months of CAPOX was cost-effective compared to 6-month in high-risk stage II and stage III CRC. Preliminary evidence suggests that biomarker approaches to AC selection in stage II can reduce costs and improve health outcomes. Notably, assessment of QALYs were predominantly reliant on a small number of non-contemporary health-utility studies. Only 32% of studies considered societal costs such as travel and time off work. Conclusions : Published economic evaluations consistently supported the use of AC in stage II and III colorectal cancer. Biomarker-driven approaches to patient selection have great potential to be cost-effective, but more robust clinical and economic evidence is warranted. Patient surveys embedded into clinical trials may address critical knowledge gaps regarding accurate assessment of QALYs and societal costs in the modern era." @default.
- W4288052129 created "2022-07-28" @default.
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- W4288052129 date "2022-07-27" @default.
- W4288052129 modified "2023-10-18" @default.
- W4288052129 title "Health economic evidence for adjuvant chemotherapy in stage II and III colorectal cancer: a systematic review" @default.
- W4288052129 doi "https://doi.org/10.21203/rs.3.rs-1879521/v1" @default.
- W4288052129 hasPublicationYear "2022" @default.
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