Authors' objectives:

To examine the clinical effectiveness and cost-effectiveness of intravenous pegylated liposomal doxorubicin hydrochloride (Caelyx, Schering-Plough Ltd, UK; Doxil, Alza Corporation, USA) as second-line treatment for advanced ovarian cancer after failure of first-line platinum-based therapy.

Authors' recommendations: The main results of this review suggested that there is little RCT evidence for assessment of the effectiveness of pegylated liposomal doxorubicin hydrochloride as second-line therapy for advanced ovarian cancer. Data from only one RCT was included in the final assessment of clinical effectiveness, and only two economic evaluations relevant to the UK NHS were identified and included in the cost-effectiveness assessment. The evidence suggested that there were no differences between pegylated liposomal doxorubicin hydrochloride and topotecan in the main clinical outcomes. However, significant differences were observed in the incidence of adverse events. The clinical significance of these findings was not discussed. Overall, the clinical effects of pegylated liposomal doxorubicin hydrochloride could at best be described as modest, however, the only other comparator considered in this review offered no real advantages. If anything, pegylated liposomal doxorubicin hydrochloride offered possible clinical advantages over topotecan due to fewer adverse events. Based on existing data, pegylated liposomal doxorubicin hydrochloride is less costly than topotecan. When effectiveness was based on survival duration, pegylated liposomal doxorubicin hydrochloride had a high probability of being cost-effective. However, differences between the two therapies are likely to exist in overall HRQoL, which, when expressed in terms of QALYs, could alter these cost-effectiveness results markedly.

Authors' methods: Systematic Review

Project Status: Completed

URL for project: http://www.hta.ac.uk/1241

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

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