Medical decision analysis for first-line therapy of chronic myeloid leukemia

被引：3

作者：

Rochau, Ursula ^{[1
,2
]}

Sroczynski, Gaby ^{[1
,2
]}

Wolf, Dominik ^{[3
,4
]}

Schmidt, Stefan ^{[3
]}

Conrads-Frank, Annette ^{[1
]}

Jahn, Beate ^{[1
,2
]}

Saverno, Kim ^{[1
,5
]}

Brixner, Diana ^{[1
,2
,5
,6
]}

Radich, Jerald ^{[7
]}

Gastl, Guenther ^{[3
]}

Siebert, Uwe ^{[1
,2
,8
,9
,10
]}

机构：

[1] UMIT Univ Hlth Sci Med Informat & Technol, Dept Publ Hlth & Hlth Technol Assessment, Inst Publ Hlth Med Decis Making & Hlth Technol As, Hall In Tirol, Austria

[2] ONCOTYROL Ctr Personalized Canc Med, Div Publ Hlth Decis Modeling Hlth Technol Assessm, Innsbruck, Austria

[3] Med Univ Innsbruck, A-6020 Innsbruck, Austria

[4] Univ Bonn, Bonn, Germany

[5] Univ Utah, Dept Pharmacotherapy, Salt Lake City, UT USA

[6] Univ Utah, Program Personalized Hlth Care, Salt Lake City, UT USA

[7] Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA

[8] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Ctr Hlth Decis Sci, Boston, MA 02115 USA

[9] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Inst Technol Assessment,Cardiovasc Res Program, Boston, MA USA

[10] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Radiol, Boston, MA USA

来源：

LEUKEMIA & LYMPHOMA | 2014年 / 55卷 / 08期

关键词：

Chronic myeloid leukemia; decision-analytic model; tyrosine kinase inhibitors; decision analysis; quality-adjusted life years;

D O I：

10.3109/10428194.2013.858149

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Several tyrosine kinase inhibitors (TKIs) are approved for the treatment of chronic myeloid leukemia (CML). Our goal was to develop a clinical decision-analytic model for evaluation of the long-term effectiveness of different therapy regimens. We developed a Markov cohort model with a lifelong time horizon for first-line treatment with imatinib, dasatinib or nilotinib. Seven strategies including combinations of TKIs, chemotherapy and stem cell transplant were evaluated. The model was parameterized using published trial data, the Austrian CML registry and practice patterns estimated by experts. Health outcomes evaluated were life-years (LYs) and quality-adjusted LYs (QALYs). Based on our decision analysis, dasatinib following nilotinib failure was the most effective treatment in terms of LYs (19.8 LYs) and QALYs (16.1 QALYs). Sensitivity analyses showed that the ranking of strategies was mostly influenced by the duration of first- and second-line therapies. Our results may support decision-making regarding the sequential application of TKIs.

引用

页码：1758 / 1767

页数：10

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