Cost Evaluation of Irinotecan-Related Toxicities Associated With the UGT1A1*28 Patient Genotype

R. Roncato, E. Cecchin, M. Montico, E. De Mattia, L. Giodini, A. Buonadonna, V. Solfrini, F. Innocenti, G. Toffoli

Research output: Research - peer-reviewArticle

  • 2 Citations

Abstract

The adoption of a preemptive UGT1A1*28 genotyping to increase irinotecan safety in clinical practice is still limited. This is the first actual study of costs associated with the management of irinotecan-related toxicities, and their association with UGT1A1*28 genotype. A retrospective analysis of the cost of toxicity management was conducted on 243 metastatic colorectal cancer patients enrolled in a clinical trial and treated with standard of care FOLFIRI (5-fluorouracil combined with irinotecan). The mean predicted cost per patient was higher for *28/*28 (€4,886), vs. *1/*1 (€812), (regression coefficient 1.79, 95% confidence interval (CI) = 1.31–2.28; P < 0.001) and for *1/*28 (€1,119) vs. *1/*1 (regression coefficient 0.32, 95% CI = 0.04–0.60; P = 0.024). This is consistent with a different grade 4 toxicity profile among the three genotypes, and a higher frequency of costly interventions like hospitalization among patients with the *28 allele. A differential toxicity management cost by *28 genotype is herein demonstrated, representing a first step towards the demonstration of the test clinical utility.

LanguageEnglish (US)
Pages123-130
Number of pages8
JournalClinical Pharmacology and Therapeutics
Volume102
Issue number1
DOIs
StatePublished - Jul 1 2017

Fingerprint

irinotecan
Genotype
Costs and Cost Analysis
Confidence Intervals
Standard of Care
Fluorouracil
Colorectal Neoplasms
Hospitalization
Alleles
Clinical Trials
Safety

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Roncato, R., Cecchin, E., Montico, M., De Mattia, E., Giodini, L., Buonadonna, A., ... Toffoli, G. (2017). Cost Evaluation of Irinotecan-Related Toxicities Associated With the UGT1A1*28 Patient Genotype. Clinical Pharmacology and Therapeutics, 102(1), 123-130. DOI: 10.1002/cpt.615

Cost Evaluation of Irinotecan-Related Toxicities Associated With the UGT1A1*28 Patient Genotype. / Roncato, R.; Cecchin, E.; Montico, M.; De Mattia, E.; Giodini, L.; Buonadonna, A.; Solfrini, V.; Innocenti, F.; Toffoli, G.

In: Clinical Pharmacology and Therapeutics, Vol. 102, No. 1, 01.07.2017, p. 123-130.

Research output: Research - peer-reviewArticle

Roncato, R, Cecchin, E, Montico, M, De Mattia, E, Giodini, L, Buonadonna, A, Solfrini, V, Innocenti, F & Toffoli, G 2017, 'Cost Evaluation of Irinotecan-Related Toxicities Associated With the UGT1A1*28 Patient Genotype' Clinical Pharmacology and Therapeutics, vol 102, no. 1, pp. 123-130. DOI: 10.1002/cpt.615
Roncato R, Cecchin E, Montico M, De Mattia E, Giodini L, Buonadonna A et al. Cost Evaluation of Irinotecan-Related Toxicities Associated With the UGT1A1*28 Patient Genotype. Clinical Pharmacology and Therapeutics. 2017 Jul 1;102(1):123-130. Available from, DOI: 10.1002/cpt.615
Roncato, R. ; Cecchin, E. ; Montico, M. ; De Mattia, E. ; Giodini, L. ; Buonadonna, A. ; Solfrini, V. ; Innocenti, F. ; Toffoli, G./ Cost Evaluation of Irinotecan-Related Toxicities Associated With the UGT1A1*28 Patient Genotype. In: Clinical Pharmacology and Therapeutics. 2017 ; Vol. 102, No. 1. pp. 123-130
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