Exploring the potential cost-effectiveness of precision medicine treatment strategies for diffuse large B-cell lymphoma

Qiushi Chen, Ashley D. Staton, Turgay Ayer, Daniel A. Goldstein, Jean L. Koff, Christopher R. Flowers

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Activated B-cell-like (ABC) diffuse large B-cell lymphoma (DLBCL) is associated with worse survival after standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) chemoimmunotherapy compared to germinal center B-cell-like (GCB) subtype. Preliminary evidence suggests that benefits from novel agents may vary by subtype. Hypothesizing that treatment stratified by DLBCL subtype could be potentially cost-effective, we developed micro-simulation models to compare three first-line treatment strategies: (1) standard RCHOP for all patients (2) subtype testing followed by RCHOP for GCB and novel treatment for ABC DLBCL, and (3) novel treatment for all patients. Based on phase 2 evidence, we used lenalidomide + RCHOP as a surrogate novel treatment. The subtype-based approach showed a favorable incremental cost-effectiveness ratio of $15,015/quality-adjusted life year compared with RCHOP. Although our exploratory analyses demonstrated a wide range of conditions where subtype-based treatment remained cost-effective, data from phase 3 trials are needed to validate our models’ findings and draw definitive conclusions.

Original languageEnglish (US)
Pages (from-to)1700-1709
Number of pages10
JournalLeukemia and Lymphoma
Volume59
Issue number7
DOIs
StatePublished - Jul 3 2018

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Exploring the potential cost-effectiveness of precision medicine treatment strategies for diffuse large B-cell lymphoma'. Together they form a unique fingerprint.

Cite this