Abstract 231P
Background
In the randomized, double-blind, phase 3 trial SOLO1, olaparib (OLA) in the maintenance setting demonstrated a 70% lower risk of disease progression or death than placebo in women with newly diagnosed advanced ovarian cancer and a BRCA1/2 mutation. This study aimed to evaluate the cost-effectiveness of OLA maintenance therapy versus routine surveillance (RS) after response to first-line platinum-based chemotherapy in this population in Singapore.
Methods
A three-state partitioned survival model was developed to simulate the lifetime (50 years) incremental cost-effectiveness ratio (ICER) of OLA versus RS from a healthcare payer perspective. Progression-free and overall survival curves were estimated using data from SOLO1 and extrapolated beyond the trial period using parametric survival models. Any patient who remained progression-free at year 7 was assumed to be a long-term survivor and no longer at risk of progression. Mortality rates for this group were modelled on all-cause mortality from the general population adjusted for BRCA1/2 mutation status. These assumptions were validated with local clinicians. Health state utilities and adverse event frequencies were obtained from SOLO1. Drug costs were sourced from local public healthcare institutions. Healthcare resource usage and costs were based on local clinician input and publications. A 3% discount rate was applied to costs and outcomes. Deterministic and probabilistic sensitivity analyses (PSA) were performed to assess the robustness of results.
Results
The base-case analysis of OLA maintenance therapy versus RS resulted in an ICER of SGD17,326 per quality-adjusted life year (QALY) gained. The ICER was most sensitive to variations in the discount rate and mortality risk in long-term survivors. PSA demonstrated that OLA was associated with an 81% probability of being cost-effective at a willingness-to-pay threshold of SGD50,000 per QALY gained.
Conclusions
OLA has a high potential of being a cost-effective maintenance therapy versus RS for patients with BRCA1/2 mutated advanced ovarian cancer after response to first-line chemotherapy in Singapore.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
AstraZeneca Singapore Pte Ltd.
Funding
AstraZeneca Singapore Pte Ltd.
Disclosure
D.S. Tan: Honoraria (self): AstraZeneca; Honoraria (self): Novartis; Honoraria (self): Roche; Honoraria (self): MSD; Honoraria (self): Bayer; Honoraria (self): Genmab; Honoraria (self): Tessa Therapeutics; Honoraria (self): Merck Serono ; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Karyopharm Therapeutics; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Roche (Foundation Medicine); Research grant / Funding (self): National Medical Research Council Singapore Clinician Scientist Award; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Roche; Advisory / Consultancy: Bayer; Advisory / Consultancy: ETC/D3 Singapore; Advisory / Consultancy: Tessa Therapeutics; Advisory / Consultancy: Genmab. J.J. Chan: Honoraria (self): Novartis; Honoraria (self): AstraZeneca; Honoraria (self): Merck Sharp & Dohme; Advisory / Consultancy: Eisai; Advisory / Consultancy: Pfizer; Research grant / Funding (institution): OncoQuest Inc; Research grant / Funding (institution): Pfizer; Travel / Accommodation / Expenses: Synthon; Travel / Accommodation / Expenses: Novartis; Travel / Accommodation / Expenses: AstraZeneca; Travel / Accommodation / Expenses: Celgene. J.K. Loke: Full / Part-time employment: AstraZeneca. R. Hettle: Full / Part-time employment: AstraZeneca. C.C. Yu: Full / Part-time employment: AstraZeneca. All other authors have declared no conflicts of interest.
Resources from the same session
15P - Comparing the outcomes of the mastectomy using the tumescent technique by between the special and non-special surgeons
Presenter: Naoya Takeda
Session: Poster display session
Resources:
Abstract
16P - Risk factors and prognostic value of non-alcoholic fatty liver disease (NAFLD) in hormone positive, non-metastatic breast cancer receiving adjuvant hormonal therapy
Presenter: Kartika Taroeno Hariadi
Session: Poster display session
Resources:
Abstract
17P - Distance related outcome in indigenous and non-indigenous breast cancer women of Western Australia
Presenter: Azim Khan
Session: Poster display session
Resources:
Abstract
18P - Usefulness of neutrophil to lymphocyte ratio in early stage breast cancer as predictor of disease-free survival in a Babylon Oncology Center
Presenter: Yaala Raof Al-Bairmany
Session: Poster display session
Resources:
Abstract
19P - Silymarin functionalized quantum cores as selective inhibitor of polo-like kinase 1, and preclinical antitumor activity in human breast cancer xenografts
Presenter: Manickam Paulpandi
Session: Poster display session
Resources:
Abstract
20P - Diagnostic value of serum HER-2 level in compression with tissue HER-2 in breast cancer: A systematic review and meta-analysis
Presenter: Amir Shamshirian
Session: Poster display session
Resources:
Abstract
21P - Clinical outcome of treatment without trastuzumab in HER2 positive breast cancer patients
Presenter: Than Than Aye
Session: Poster display session
Resources:
Abstract
22P - Clinical outcomes after skin-sparing or nipple areolar complex-sparing mastectomy with sentinel lymph node biopsy in early breast cancer patients
Presenter: Hye Yoon Lee
Session: Poster display session
Resources:
Abstract
23P - The correlations between knowledge and attitudes of productive age women toward “SADARI” (breast self-assessment) as early detection of breast cancer in Pejeng Kaja Village, Ubud, Bali
Presenter: Yorky Brahmantya
Session: Poster display session
Resources:
Abstract
24TiP - KEYNOTE-756: A randomized, double-blind, phase III study of pembrolizumab or placebo with neoadjuvant chemotherapy and adjuvant endocrine therapy for high-risk, early-stage, ER+/HER2−breast cancer
Presenter: Fatima Cardoso
Session: Poster display session
Resources:
Abstract