The CancerWeb Report, What's New In Cancer: February, 1997
Ovarian Cancer

• Cost analyses of treating advanced ovarian cancer - Health-care costs have been rising rapidly, and cost-containment is the new watchword motivating care-providers and insurers alike. Cancer care is certainly not exempt from this, but with much cancer treatment being to varying extents experimental and thus expensive, it is important to have reliable information on which to base choices. Two reports in the February, 1997 issue of the Journal of Clinical Oncology come to opposite conclusions regarding the cost implications of treating advanced ovarian cancer with regimens containing paclitaxel (Taxol). Both studies used data from the same clinical study (Protocol 111 of the US Gynecology Oncology Group) comparing standard therapy using cisplatin/cyclophosphamide with cisplatin/paclitaxel. One study from a number of major Canadian institutions, concluded that while the paclitaxel therapy extended survival the benefit did not match the significantly greater cost. The paclitaxel therapy increased the average survival time from 2.06 to 2.44 years (an increase of about 18 weeks ) at a cost of 17,469 versus 5,228 Canadian dollars, or 32,213 dollars per year of life gained. The researchers calculated the additional cost to Ontario government as 9 million dollars annually (Elit, J Clin Oncol 15:632, 1997). In contrast, several US institutions concluded that the additional costs involved, 19,820 for inpatient and 21,222 for outpatient treatment per year of life gained, were reasonable McGuire, J Clin Oncol 15:640, 1997). It is apparent that one can arrive at opposite conclusions from the same data, since the Canadian cost estimate translates to about 23,670 US dollars, close to the US value.

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• French study suggests the value of a new platinum-containing drug - Drugs containing platinum, such as cisplatin and carboplatin, are among the most active in treating advanced ovarian cancer. Unfortunately, resistance develops to these drugs, and there are few options then available to women with this disease. Oxaliplatin is a platinum-containing drug with a different type of chemical structure that does not appear to have cross-resistance with other platinum drugs. Researchers in France, including a group at Sanofi-Winthrop and the major cancer center at Villejuif, tried oxaliplatin in patients with advanced ovarian cancer who had failed after an average of three chemotherapy regimens. Of 31 patients whose disease could be evaluated accurately, 29% showed objective responses, a high rate for this poor-prognosis group. (Chollet, Annals Oncology 7:1065, 1996)