Authors' objectives:

"The main aim of this review is to assess the clinical effectiveness and cost-effectiveness of bevacizumab and cetuximab in the treatment of individuals with metastatic CRC.

More specifically, the objectives of the review are:

to evaluate the relative clinical effectiveness of bevacizumab and cetuximab in terms of progression-free survival, overall survival, tumour response rates, time to treatment failure and HRQoL compared with current standard therapies to evaluate the adverse effect profiles of bevacizumab and cetuximab to estimate the incremental cost-effectiveness of bevacizumab and cetuximab compared with current standard therapies to estimate the annual cost to the NHS in England and Wales." (from executive summary)

Authors' recommendations: The trials indicate that bevacizumab in combination with 5-FU/FA and bevacizumab in combination with IFL are clinically effective in comparison with standard chemotherapy options for the first-line treatment of metastatic CRC. The health economic analysis suggests that the marginal cost;utility of bevacizumab plus IFL versus IFL is unlikely to be better than 62,857 per QALY gained and the marginal cost;utility of bevacizumab plus 5-FU/FA versus 5-FU/FA is unlikely to be better than 88,658 per QALY gained. There is no direct evidence to demonstrate whether cetuximab in combination with irinotecan improves HRQoL or OS in comparison with active/best supportive care or oxaliplatin plus 5-FU/FA, although the evidence on tumour response rates suggests that cetuximab plus irinotecan has some clinical activity. Although it is difficult to suggest whether cetuximab represents value for money, as its comparative efficacy remains unknown, indirect comparisons suggest that the incremental cost;utility of cetuximab plus irinotecan is unlikely to be better than 30,000 per QALY gained.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.hta.ac.uk/1490

Year Published: 2007

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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