The pharmacological costs of complete liver resections in unselected advanced colorectal cancer patients: a review of published Phase II and III trials

Abstract

The pharmacological costs of regimens used as front-line therapy in advanced colorectal cancer patients and their impact on the liver resection rates have not been considered. In this paper, we made a review of published randomized Phase II and III trials that reported the liver resection rates following upfront chemotherapy and linked this outcome to the pharmacological costs of drugs used. The costs are calculated based on the price at Pharmacy of our Hospital in Legnago (Italy), and as a measure of activity, we used the number of patients needed to treat to get one complete liver resection. Number needed to treat is highly variable among the different trials according to patient’s characteristics, tumor biology and the efficacy of chemotherapy administered. The range of activity is greatly amplified when the costs are compared.

Keywords:

• advanced colorectal cancer
• costs of drugs
• first line chemotherapy
• randomized Phase II and Phase III trials

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includesemployment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The pharmacological costs of commonly used frontline regimens for the treatment of advanced colorectal cancer are highly variable.

• The performance of the published chemotherapy schemes, in terms of resection rates, depends on the patient’s selection, tumor characteristics and the type of the scheme.

• The costs of conversion therapy are highly variable.