BACKGROUND: The 70-gene signature (MammaPrint) is a prognostic test used to guide adjuvant treatment decisions in patients with node-negative breast cancer. In order to decide upon its use, a systematic comparative analysis of the effects of the 70-gene signature, the Sankt Gallen guidelines and the Adjuvant Online Software for these patients on survival, quality of life and costs is warranted. METHODS: A Markov decision model was used to simulate the 20-year costs and outcomes (survival and quality-of-life adjusted survival (QALYs)) in a hypothetical cohort of node-negative, estrogen receptor positive breast cancer patients. Sensitivity and specificity of the three prognostic tools were based on 5 and 10 years breast cancer specific survival and distant metastasis as first event, derived from a pooled analysis consisting of 305 tumour samples from 3 previously reported validation studies concerning the 70-gene signature. RESULTS: Small differences in survival, but substantial differences in quality-adjusted survival between the prognostic tools were observed. Quality-adjusted survival was highest when using the 70-gene signature. Based on costs per QALY, the 70-gene has the highest probability of being cost-effective for a willingness to pay for a QALY higher than euro12.000. Sankt Gallen showed the highest survival rates compared to the 70-gene signature, but leads to a substantial larger amount of adjuvant chemotherapy and lower cost-effectiveness, thus demanding a high willingness to pay to save a life year. CONCLUSIONS: When deciding upon the cost-effectiveness of the prognostic tests, the 70-gene signature improves quality-adjusted survival and has the highest probability of being cost-effective. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
BACKGROUND: The 70-gene signature (MammaPrint) is a prognostic test used to guide adjuvant treatment decisions in patients with node-negative breast cancer. In order to decide upon its use, a systematic comparative analysis of the effects of the 70-gene signature, the Sankt Gallen guidelines and the Adjuvant Online Software for these patients on survival, quality of life and costs is warranted. METHODS: A Markov decision model was used to simulate the 20-year costs and outcomes (survival and quality-of-life adjusted survival (QALYs)) in a hypothetical cohort of node-negative, estrogen receptor positive breast cancerpatients. Sensitivity and specificity of the three prognostic tools were based on 5 and 10 years breast cancer specific survival and distant metastasis as first event, derived from a pooled analysis consisting of 305 tumour samples from 3 previously reported validation studies concerning the 70-gene signature. RESULTS: Small differences in survival, but substantial differences in quality-adjusted survival between the prognostic tools were observed. Quality-adjusted survival was highest when using the 70-gene signature. Based on costs per QALY, the 70-gene has the highest probability of being cost-effective for a willingness to pay for a QALY higher than euro12.000. Sankt Gallen showed the highest survival rates compared to the 70-gene signature, but leads to a substantial larger amount of adjuvant chemotherapy and lower cost-effectiveness, thus demanding a high willingness to pay to save a life year. CONCLUSIONS: When deciding upon the cost-effectiveness of the prognostic tests, the 70-gene signature improves quality-adjusted survival and has the highest probability of being cost-effective. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Authors: S Pérez Ramírez; M Del Monte-Millán; S López-Tarruella; N Martínez Jáñez; I Márquez-Rodas; F Lobo Samper; Y Izarzugaza Perón; C Rubio Terres; D Rubio Rodríguez; J Á García-Sáenz; F Moreno Antón; P Zamora Auñón; M Arroyo Yustos; M Á Lara Álvarez; E M Ciruelos Gil; L Manso Sánchez; M J Echarri González; J A Guerra Martínez; C Jara Sánchez; C Bueno Muiño; S García Adrián; J R Carrión Galindo; V Valentín Maganto; M Martín Journal: Clin Transl Oncol Date: 2019-07-12 Impact factor: 3.405
Authors: Janne C Mewes; Lotte M G Steuten; Saskia F A Duijts; Hester S A Oldenburg; Marc van Beurden; Martijn M Stuiver; Myra S Hunter; Jacobien M Kieffer; Wim H van Harten; Neil K Aaronson Journal: J Cancer Surviv Date: 2014-09-02 Impact factor: 4.442