Cost-Effectiveness of Temozolamide for Treatment of Glioblastoma Multiforme in India

Gupta, Nidhi; Prinja, Shankar; Patil, Vijay; Bahuguna, Pankaj

doi:10.1200/go.20.00288

Cited by 17 publications

(9 citation statements)

References 35 publications

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“…A variety of therapeutic approaches have been developed to treat glioblastoma multiforme and differ in terms of targeting either the tumor cells or enhancing the anti-cancer immune response; many factors influence the choice for the most suitable option in each cancer patient, which can be influenced by either tumor-associated factors or patient-and physician-associated factors. However, the ultimate goal of all treatments is to eradicate the glioblastoma multiforme cells, minimize the sequelae of treatment, preserve or restore form and function, and prevent any potential subsequent primary cancers [37][38][39] . Table 1 presents a summary of the current therapeutic options for glioblastoma multiforme.…”

Section: Therapeutic Approaches Of Glioblastoma Multiformementioning

confidence: 99%

Novel Insights into Genetic Approaches in Glioblastoma Multiforme Therapy

et al. 2022

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Glioblastoma multiforme is one of the most common and malignant types of central nervous system (CNS) tumors. Despite the great advances in treatment modalities and the variety of therapeutic options, it remains largely incurable with continuously growth incidence, due to the genomic instability of glioblastoma multiforme cells, their heterogeneity, and their resistance to chemo-and radiotherapies. The aggressive behavior of these brain tumors and their sequestered location behind the blood-brain barrier restricts the role of the immune system. Great success has been made recently in glioblastoma multiforme treatment using genetic based approaches to selectively target cancerous cells and restore tumor suppressor gene expression or silence specific oncogenes to prevent their expression. The use of genetic approaches has attracted more interest and research and has revealed their ability to regulate the expression of glioblastoma multiforme oncogenes without changing the genotype and thus avoiding possible genotoxicity. This review delivers an overview of glioblastoma multiforme cell biology, tumorigenesis, and immune surveillance, and discusses recent advances in genetic based therapies of glioblastoma multiforme.

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Section: Therapeutic Approaches Of Glioblastoma Multiformementioning

confidence: 99%

Novel Insights into Genetic Approaches in Glioblastoma Multiforme Therapy

et al. 2022

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“…In a third recent study, use of the adjuvant temozolomide along with radiation therapy for treatment of glioblastoma multiforme was not found to be cost-effective. 17…”

Section: Clinical Contextmentioning

confidence: 99%

“…Clinical guidelines continue to recommend dosage of 1 year of trastuzumab, sorafenib, as well as temozolomide. 15 16 17 Integration of this with economic evidence specific to India in the clinical recommendations will help to attain greater health benefits at a population level. This will only be possible by optimal utilization of the limited resources.…”

Section: Clinical Contextmentioning

confidence: 99%

Application of Health Technology Assessment for Oncology Care in India: Implications for Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana

Gupta

Jyani

Rajsekar

et al. 2021

Indian J Med Paediatr Oncol

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A health system is considered efficient when it provides maximum health gains to the population from the available resources. Newer drugs, diagnostics and treatment strategies aim to improve the health of the population, however, they come at an increased cost. Therefore, for an efficient health system, it needs to be decided if the extra cost being incurred is justified to achieve the extra health gains. In this regard, health technology assessment (HTA) helps to make evidence informed decisions by evaluating relative cost and benefits of the available interventions. Economic evidence generated by HTA can also be used in framing standard treatment guidelines (STGs) for high-cost cancer care. In multi-payer systems like India, the decisions regarding the clinical management of patients are taken based on the patients' ability to pay, which creates inequities in utilization of healthcare. Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) offers an opportunity to ensure equity as it reduces financial barriers, besides having a potential to affect efficiency by including only cost-effective interventions in the benefit package. As a result, informed clinical decisions based upon HTA evidence can make cancer treatment more efficient, equitable and affordable for the patients.

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“…The treatment typically consists of maximally safe surgical resection (without affecting vital body functions) and subsequent adjuvant radiotherapy lasting for 6 weeks (Cabrera et al, 2016). Addition of several chemotherapeutic drugs such as temozolomide ( 1 , Chart 1) to the treatment regimen concomitant with radiotherapy and the following maintenance therapy, have altered the overall survival landscape, albeit by meagre 2.5 months (Gupta et al, 2021). Despite the lower incidence of GBM globally and locally, for example, India, the “average years of life lost” figures are scary due to the very fact that it affects adults at any stage of life (Burnet et al, 2005; Oronsky et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Hit discovery of novel 2‐phenyl‐substituted 4‐amino–6,7‐dihydro‐5H‐cyclopenta[d]pyrimidines as potential anti‐glioblastoma therapeutics: Design, synthesis, biological evaluation, and computational screening

Khairnar

Sonawane

Cheke

et al. 2023

Drug Development Research

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Glioblastoma multiforme (GBM) is a highly‐aggressive, dreadful disease with poor prognosis and disappointing clinical success. There is an unmet medical need of molecularly‐targeted therapeutics for GBM treatment. In the present work, a series of novel 2‐phenyl‐substituted 4‐amino–6,7‐dihydro‐5H‐cyclopenta[d]pyrimidines was designed, synthesized, purified, characterized, and evaluated for cytotoxicity against glioblastoma cell line U87‐MG. The design process (virtual library enumeration around the core, physicochemical and molecular property prediction/calculation of the designs, filtering the undesirable ones, and the diversity analyses of the lead‐like designs), was carefully curated so as to obtain a set of structurally‐diverse, novel molecules (total 20), with a particular focus on the relatively unexplored core structure, 6,7‐dihydro‐5H‐cyclopenta[d]pyrimidine. The preliminary screening was done using MTT assay at 10 and 100 μM concentrations of the title compounds F1−F20 and positive control cisplatin, which yielded six hits (% inhibition at 10 μM: ~50%)—F2, F3, F5, F7, F15, and F20, which were taken up for IC50 determination. The top hits F2 and F7 (IC50 < 10 μM) were further used for computational studies such as target prediction, followed by their molecular docking in the binding sites of the top‐3 predicted targets (epidermal growth factor receptor kinase domain, cyclin‐dependent kinase 2 [CDK2]) /cyclin E, and anaplastic lymphoma kinase [ALK]). The docking pose analyses revealed interesting trends. The relatively planar core structure, presence of favorable hinge‐binding substructures, basic groups, all added up, and culminated in appreciable cytotoxicity against GBM cell line.

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Cost-Effectiveness of Temozolamide for Treatment of Glioblastoma Multiforme in India

Cited by 17 publications

References 35 publications

Novel Insights into Genetic Approaches in Glioblastoma Multiforme Therapy

Novel Insights into Genetic Approaches in Glioblastoma Multiforme Therapy

Application of Health Technology Assessment for Oncology Care in India: Implications for Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana

Hit discovery of novel 2‐phenyl‐substituted 4‐amino–6,7‐dihydro‐5H‐cyclopenta[d]pyrimidines as potential anti‐glioblastoma therapeutics: Design, synthesis, biological evaluation, and computational screening

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