|

Choosing the Right Mesothelioma Treatment: A Cost-Effective Perspective

ByHolly Zink
Choosing the Right Mesothelioma Treatment: A Cost-Effective Perspective

A recent study unveiled intriguing findings about the cost-effectiveness of mesothelioma treatments. Standard chemotherapy is the tried-and-true pemetrexed plus cisplatin combination. But how does it measure up against a newer but pricier alternative, nivolumab plus ipilimumab?

The Gold Standard Treatment

Malignant pleural mesothelioma is an aggressive type of cancer that affects the lining of the lungs. It is caused by exposure to a toxic mineral called asbestos. Conventional treatments for mesothelioma generally consist of chemotherapy, surgery, and sometimes radiation therapy.

The standard chemotherapy treatment for mesothelioma is a combination of two drugs called pemetrexed and cisplatin.  This is the only FDA-approved chemotherapy regimen for mesothelioma.

Recently, a new combination of drugs has been found to be even better at shrinking mesothelioma tumors. This new combination is called nivolumab and ipilimumab. But even though it is an effective treatment, it is also expensive.

Balancing Hope and Economics

Scientists looked at data from a big study called CheckMate 743. They used a special computer program to make a model. The model compared the costs and benefits of nivolumab with ipilimumab with the standard chemotherapy drugs. They looked at this over a period of 10 years.

The model showed that nivolumab with ipilimumab was more expensive than the usual chemotherapy. They used a special number called ICER to compare the two drug combinations. For all the patients in the study, the ICER for nivolumab with ipilimumab was $375,656 for each year of good quality life it gave. For patients with the epitheliod type of mesothelioma, it was $327,943. For patients with non-epithelioid types of mesothelioma, it was $115,495.

In simpler terms, this means that using nivolumab with ipilimumab was a lot more expensive than the usual chemotherapy drugs. The cost was much higher than what is usually considered reasonable in healthcare.

In China, where the study focused, it seems that the usual chemotherapy might be a better choice financially. The new treatment combination of nivolumab with ipilimumab was more expensive and didn’t seem to give enough extra benefit to justify the cost.

Source

Yang L, Song X, Zeng W, Zheng Z, Lin W. First-line nivolumab plus ipilimumab for unresectable MPM in China: a cost-effectiveness analysis. Orphanet J Rare Dis. 2023;18(1):326. Published 2023 Oct 16. doi:10.1186/s13023-023-02925-w. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580582/

Similar Posts

  • | |

    Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma

    ByAlex Strauss

    A team of medical researchers in Italy have achieved what they are calling “excellent” tumor control and survival results in malignant pleural mesothelioma patients using a combination of surgery, chemotherapy, and radiotherapy. Caused by exposure to asbestos, mesothelioma typically spreads quickly across the lung-encasing membrane called the pleura. There is no known cure but treatments are improving. In the current prospective study, 20 malignant pleural mesothelioma patients underwent radical pleurectomy/decortication followed by high doses of radiation. After surgeons removed as much of the visible mesothelioma tumor and surrounding tissue as possible, patients received 50Gy of radiation to the effected side of their chest, delivered in 25 fractions. Regions of particular concern for mesothelioma regrowth got an extra radiation “boost” to…

  • | |

    Does Radiotherapy Reduce Mesothelioma Pain?

    ByAlex Strauss

    A new study says there is not enough evidence to support the use of radiotherapy for the treatment of pain associated with malignant pleural mesothelioma. Researchers at the University of Edinburgh in Scotland reviewed a range of past studies on mesothelioma pain and radiotherapy by searching databases that date back as far as 1974. To be eligible to be included in their review, the study had to focus on malignant pleural mesothelioma and radiotherapy given “with the intent of improving pain”. The study also had to report doses and fractionation of the radiotherapy and how the pain responded. In all, the researchers found eight studies on mesothelioma pain and radiotherapy that met the criteria. Two of the studies were prospective…

  • | |

    Radiotherapy for Mesothelioma: Better But Still Limited

    ByAlex Strauss

    A form of highly-targeted radiation therapy for mesothelioma is better than it used to be, but is still risky. That is the message of a recent article on intensity-modulated radiation therapy (IMRT) in Seminars in Thoracic and Cardiovascular Surgery. Author Kenneth E. Rosenzweig, MD, a Radiation Oncologist with Mount Sinai Hospital in New York, reviewed recent studies on IMRT and mesothelioma. He concludes that, while the “troubling toxicity” associated with IMRT when it was first introduced has not been entirely eliminated, the fact that clinicians now have more experience with it is making a positive difference for mesothelioma patients. Before targeted therapies like IMRT were available, high-dose radiation was not usually a feasible option for mesothelioma since the irregular shape…

  • | |

    A Second-Line Option for Mesothelioma?

    ByAlex Strauss

    Although survival was not significantly extended, the chemotherapy drug vinorelbine might be a treatment option for mesothelioma patients whose cancer has returned after first-line chemotherapy with pemetrexed. A new study on vinorelbine as a second-line treatment finds that the drug is “moderately active” in mesothelioma patients who were initially treated with pemetrexed-based chemotherapy. Pemetrexed (Alimta), along with a platinum-based drug like cisplatin, is the primary first-line drug therapy for mesothelioma. But vinorelbine is gaining attention as a possible option for mesothelioma, in part because it is available in a less expensive generic form. In “Vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma”, the Italian authors detail the results of their study on 59 patients with unresectable pleural mesothelioma.  These patients…

  • | |

    Repeat HIPEC Improves Mesothelioma Survival

    ByAlex Strauss

    If one cytoreductive surgery and HIPEC procedure for mesothelioma is good, subsequent treatments may be even better. That is the central message of research conducted at the Moffitt Cancer Center in Florida. The study’s aim was to assess overall survival among peritoneal mesothelioma patients who had not just one, but two or more rounds of heated intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery. The cytoreduction/HIPEC approach has become popular for peritoneal mesothelioma, a treatment-resistant cancer of abdominal membranes caused by asbestos. Cytoreductive surgery involves removing as much of the mesothelioma tumor as possible from the abdomen. Because the shape and spreading pattern of mesothelioma tumors make complete cytoreduction difficult, the surgery is often followed by a rinse with a heated solution…

  • | |

    Value of Mesothelioma Surgery Challenged for Healthy Patients

    ByAlex Strauss

    New research conducted in Italy and presented at the 15th World Conference on Lung Cancer in Sydney, Australia suggests that mesothelioma surgery – no matter what kind – may not offer a survival advantage over medical management for the healthiest of patients. Mesothelioma is a rare but aggressive malignancy that is highly resistant to standard cancer treatments. The two types of mesothelioma surgery considered to be options for people with resectable cancer are pleurectomy decortication (P/D) or extrapleural pneumonectomy (EPP). While EPP is more radical than P/D because it involves removing a lung, both carry a heavy risk of complications and, according to the Italian researchers, may not be of value for certain patients. The study reviewed data from 1,365…