Roncato R.,Centro Of Riferimento Oncologico |
Cecchin E.,Centro Of Riferimento Oncologico |
Montico M.,Centro Of Riferimento Oncologico |
De Mattia E.,Centro Of Riferimento Oncologico |
And 5 more authors.
Clinical Pharmacology and Therapeutics | Year: 2017
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. © 2017 American Society for Clinical Pharmacology and Therapeutics.