Navigation Links
Many patients with advanced cancers get treatments that won't help
Date:6/7/2011

A study of more than 1,000 patients with colon cancer that had spread to distant sites found that one in eight was treated with at least one drug regimen that was not recommended. Those patients were exposed to significant risk without proven benefits, at an estimated costjust for the drugsof more than $2 million.

The study, presented June 7, 2011, by University of Chicago researchers at the American Society for Clinical Oncology's annual meeting in Chicago, focused on three chemotherapy regimens that were not supported by evidence from prior clinical studies or clinical practice guidelines. One treatment was rated "insufficient data to support," one had been "shown to be ineffective," and one was supported by "no data, nor is there a compelling rationale."

"Patients with advanced cancers that do not respond to standard therapies should either be looking for clinical trials, where there is a chance for a benefit, or should have been thinking about shifting toward palliative care," said study author Jonas De Souza, M.D., a hematology/oncology fellow at the University of Chicago. "Patients should not face the risks, discomforts and costs of aggressive and often quite toxic chemotherapy with treatment regimens that did not provide a benefit in previous studies."

Under an agreement with UnitedHealthcare, a health benefits business, the researchers used de-identified medical and pharmaceutical claims data in the collaborative project. They examined claims from 7,642 colon cancer cases treated between January 2007 and June 2010, including 1,041 who developed metastatic disease. Of those 1,041 patients, 140 (13%) received treatments that were not supported by the evidence from clinical studies. Many of them received multiple cycles of non-beneficial chemotherapy.

The researchers focused on three chemotherapy regimens with specific recommendations against their use in the National Comprehensive Cancer Network (NCCN) guidelines. The regimen with insufficient data involved bevacizumab (trade name Avastin) used after the patient had progressed on a combination of that drug and chemotherapy. The treatment shown to be "ineffective" was capecitabine (trade name Xeloda) after progression on the same class of drugs. The regimen with no compelling rationale was panitumumab or cetuximab (trade name Erbitux) after progression on similar drugs.

The 140 patients received 869 cycles of chemotherapy. Some received two or more unproven treatments.

  • Ninety-one of those patients went through 632 intravenous cycles of bevacizumab, at an estimated cost of $1.3 million. Potential side effects include hypertension, heightened risk of bleeding and bowel perforation.
  • Fifty-nine patients received 218 non-evidence-based cycles of capecitabine, at a cost of more than $600,000. This drug, taken orally, can cause diarrhea, nausea, vomiting, fatigue, rash and swelling of the hands or feet.
  • Six patients underwent 19 cycles of panitumumab, at a cost of almost $70,000. This drug can trigger itching, dermatitis and rash.

"We did not study why these physicians and patients turned to unproven therapies," said co-author Caleb Alexander, M.D., associate professor of medicine at the University of Chicago. "I suspect that both patients and care providers, when facing life-threatening disease with limited options, are more willing to step outside guidelines."

"There could also be financial implications," he added. "A physician who has run out of options may be hesitant to send a patient to a center that has access to greater resources but may be far away."

The researchers emphasized, however, that as the costs of cancer care continue to rise, the impetus to base treatment decisions on solid evidence can only increase. "It's important to get the right medicines to the right patients," said Alexander.

"DeSouza's research highlights the importance of evidence-based treatment for cancer patients," said Lee Newcomer, M.D., UnitedHealthcare's senior vice president, oncology. "Expert oncology opinions tell us that the extra therapies that these patients received potentially exposed these patients to unnecessary side effects. We should be relieving symptoms and not causing new ones, even as we try to address the underlying disease."


'/>"/>

Contact: John Easton
John.Easton@uchospitals.edu
773-702-6241
University of Chicago Medical Center
Source:Eurekalert

Related medicine news :

1. ICU Patients at Risk for Rare Heart Rhythm Problem
2. Young patients with chronic illnesses find relief in acupuncture
3. For Some Breast Cancer Patients, Shorter Radiation Works Well
4. New Study Uses Adult Stem Cells in Effort to Save Limbs of Patients with Peripheral Arterial Disease
5. Patients with Lethal Lung Disease Finally Receive Recognition by Social Security Administration
6. Behavioral therapy improves sleep and lives of patients with pain
7. Protecting patients: Study shows that Johns Hopkins flu vaccination rates twice national average
8. MSU researcher linking breast cancer patients with alternative therapies
9. New American Heart Association Survey Finds Heart Disease and Stroke Patients Face Significant Barriers in Obtaining Quality, Affordable Care
10. Fishy Smell May Keep Patients From Diabetes Drug
11. AGA offers new recommendations for CRC surveillance for certain patients with IBD
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/22/2017)... ... March 22, 2017 , ... Intrinsic ... extensive therapeutic experience and operational excellence in oncology clinical trials, proudly announces today ... the treatment of non-small cell lung cancer and small cell lung cancer. , ...
(Date:3/22/2017)... East Norwich, NY (PRWEB) , ... March 22, 2017 , ... ... services to communities in the greater Nassau County region, is embarking on a combined ... with breast cancer. , For the last 25 years, the Great Neck Breast ...
(Date:3/22/2017)... ... , ... Schneider Insurance and Financial, a southern Montana firm providing asset protection ... is launching a charity event aimed at raising local support for Zoo Montana. , ... and is home to a broad variety of animals from all over the world. ...
(Date:3/22/2017)... (PRWEB) , ... March 22, 2017 , ... ... asset protection services and financial planning assistance to communities throughout central Ohio, is ... Brain Injuries. , Estimates from the Department of Defense and the Veteran's Brain ...
(Date:3/22/2017)... ... ... HumanHaus is proud to announce the launch of its newest invention on crowdfunding ... invented, but our customers today are busy, energetic, multi-taskers that live in a smarter ... and retired that want to travel. The Sweep&Stand is a self-standing broom ...
Breaking Medicine News(10 mins):
(Date:3/22/2017)... , March 22, 2017  Applied BioMath ( ... to drug research and development, today announced the ... QSP Day 2017 is a day full of ... systems pharmacology (QSP) community. The focus is to ... de-risking and accelerating drug research and development. ...
(Date:3/22/2017)... March 22, 2017 National Medical Products ... received an Innovative Technology contract from Vizient, ... in the country. The contract was based on ... with expertise in this category who serve on ... Technology contracts for technologies that demonstrate an ability ...
(Date:3/22/2017)...   Upsher-Smith Laboratories, Inc . (Upsher-Smith) today announced the ... mg and 75 mg, the generic equivalent to Mallinckrodt Pharmaceuticals, ... The clomipramine hydrochloride capsules market had U.S. sales of approximately ... to IMS Health. ... "Upsher-Smith has long been recognized within the pharmaceutical ...
Breaking Medicine Technology: