Cost Analysis of Capecitabine vs 5-Fluorouracil-Based Treatment for Metastatic Colorectal Cancer Patients

Portu, Simona de; Mantovani, Luisa; Ravaioli, Alberto; Tamburini, Emiliano; Bollina, R.; Cozzi, C.; Grimaldi, Antonio; Testa, T; Bianchessi, Clara; Cartenì, Giacomo

doi:10.1179/joc.2010.22.2.125

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…Oral administration is an appealing drug delivery way owing to the simplicity, convenience, high patient compliance, suitability for chronic therapy and reduced costs for physicians and industry 130 , 131 . However, there are still numerous inherent challenges hampering the effective delivery of drugs, such as low water solubility, limited permeability through the gastrointestinal tract, poor stability against enzymes and hydrolysis effect, which lead to poor absorption and bioavailability 132 .…”

Section: Unmodified Tpgs Based Formulationsmentioning

confidence: 99%

Recent Advances in the Application of Vitamin E TPGS for Drug Delivery

et al. 2018

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D-ɑ-tocopheryl polyethylene glycol succinate (Vitamin E TPGS or TPGS) has been approved by FDA as a safe adjuvant and widely used in drug delivery systems. The biological and physicochemical properties of TPGS provide multiple advantages for its applications in drug delivery like high biocompatibility, enhancement of drug solubility, improvement of drug permeation and selective antitumor activity. Notably, TPGS can inhibit the activity of ATP dependent P-glycoprotein and act as a potent excipient for overcoming multi-drug resistance (MDR) in tumor. In this review, we aim to discuss the recent advances of TPGS in drug delivery including TPGS based prodrugs, nitric oxide donor and polymers, and unmodified TPGS based formulations. These potential applications are focused on enhancing delivery efficiency as well as the therapeutic effect of agents, especially on overcoming MDR of tumors. It also demonstrates that the clinical translation of TPGS based nanomedicines is still faced with many challenges, which requires more detailed study on TPGS properties and based delivery system in the future.

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Section: Unmodified Tpgs Based Formulationsmentioning

confidence: 99%

Recent Advances in the Application of Vitamin E TPGS for Drug Delivery

et al. 2018

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“…In this light, the use of oral cancer therapies, which is becoming increasingly common in clinical oncology,6,7 represents a promising therapeutic strategy. The advent of oral chemotherapy has had a strong impact on several aspects of the management of cancer patients, including survival rates, health-care expenditure, and health-related quality of life 8–10. As an example, the selective tyrosine kinase inhibitor imatinib mesylate has been shown to be highly effective in patients with unresectable or metastatic gastrointestinal stromal tumor – a cancer associated with unfavorable outcomes and resistance to conventional chemo-or radiotherapy 11,12.…”

Section: Introductionmentioning

confidence: 99%

Effect of a structured, active, home-based cancer-treatment program for the management of patients on oral chemotherapy

Bordonaro¹,

Romano²,

Lanteri³

et al. 2014

PPA

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IntroductionThe advent of oral chemotherapy agents has had a strong impact on several aspects of the management of cancer patients, including survival rates, health-care expenditure, and health-related quality of life. However, access to care and adherence to oral chemotherapy are central to optimal outcomes.Patients and methodsIn this multicenter observational study, we assessed the effect of the “Active Home Care” initiative – a structured, active, home-based cancer-treatment program – on quality of life, health-care utilization, and patient adherence and satisfaction using self-administered questionnaires. Sixty-two patients treated with oral chemotherapy (capecitabine, vinorelbine, imatinib, sunitinib, sorafenib, temozolomide, ibandronate) were enrolled in the program. Weekly home visits were scheduled, each one with a trained nurse who delivered the home-based chemotherapy and reviewed patients’ compliance and treatment toxicity. An oncologist evaluated patients and modified the dosage of oral chemotherapy based on toxicity reported during the previous cycle at bi-weekly visits.ResultsA total of 460 home visits were performed between April 2012 and February 2013. The Active Home Care initiative was associated with significant improvements in physical functioning and symptoms, and reductions in the access to cancer facilities. Satisfaction with oral chemotherapy and care received was high. All patients reported having taken their medications according to their prescription, and no patient reported difficulties in managing the oral chemotherapy regimen.ConclusionThe Active Home Care program was associated with improvements in the quality of life of patients and caregivers, better adherence to treatment, and the effective management of therapy and cancer-related symptoms. Home-based cancer treatment may also optimize the utilization of health-care resources.

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“…The finding that combination of oral FP-based chemotherapy and cetuximab is a valid alternative to infusional FP in Chinese patients is important. It has been shown that oral fluoropyrimidine is more cost-effective and more preferred among patients[12-14]. In addition, infusional FP requires more hospital stay and venous access.…”

Section: Discussionmentioning

confidence: 99%

“…The demonstration of non-inferiority of oral FP versus infusional FP in combination with cetuximab carries important implications as oral FP offers potential advantages over infusional FP. First, oral FP is more cost effective with lower direct cost[12,13]. Second, studies also showed higher patient preference for oral FP as it is more convenient and reduces the need of hospital admission[13,14].…”

Section: Introductionmentioning

confidence: 99%

Revisiting oral fluoropyrimidine with cetuximab in metastatic colorectal cancer: Real-world data in Chinese population

Lam

Lau

et al. 2019

WJGO

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BACKGROUNDCetuximab in combination with oral fluoropyrimidine (FP) remains controversial in metastatic colorectal cancer (mCRC). In view of the regional variation in the tolerability of FP, we conducted a retrospective analysis to compare oral FP with infusional FP in combination with cetuximab in Chinese population.AIMTo compare the efficacy and safety profile of cetuximab in combination with oral FP and infusional FP in Chinese population in the real-world setting.METHODSA retrospective cohort study was done to analyse consecutive patients with Kras wild-type mCRC who received first-line treatment with cetuximab and FP-based chemotherapy in our unit from January 2010 to December 2015. Ninety-five eligible patients were included. The median follow-up of our cohort was 65.0 mo.RESULTSThe median progression-free survival (mPFS) and median overall survival (mOS) of the entire cohort were 9.66 mo (95%CI: 7.72–12.5) and 25.8 mo (95%CI: 18.7–35.6), respectively. Between oral FP and infusional FP, there was no statistical significant difference in the mPFS [9.79 mo (95%CI: 7.49–12.7) vs 9.63 mo (95%CI: 6.34–13.4); P = 0.72] and mOS [25.8 mo (95%CI: 15.2–35.6) vs 26.3 mo (95%CI: 18.7–41.2); P = 0.63]. Grade 3 or above adverse events were reported in 28.4% of patients, being similar with oral and infusional FP, and included 10.5% of neutropenia and 2.1% of diarrhoea events.CONCLUSIONThe current analysis demonstrates comparable efficacy and safety profiles of cetuximab in combination with oral and infusional FP in Chinese population. The results expand treatment options for Chinese patients and invite revision of existing treatment guidelines to incorporate oral FP-based chemotherapy plus cetuximab.

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Cost Analysis of Capecitabine vs 5-Fluorouracil-Based Treatment for Metastatic Colorectal Cancer Patients

Cited by 14 publications

References 16 publications

Recent Advances in the Application of Vitamin E TPGS for Drug Delivery

Recent Advances in the Application of Vitamin E TPGS for Drug Delivery

Effect of a structured, active, home-based cancer-treatment program for the management of patients on oral chemotherapy

Revisiting oral fluoropyrimidine with cetuximab in metastatic colorectal cancer: Real-world data in Chinese population

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