Survival outcome and cost-effectiveness with docetaxel and paclitaxel in patients with metastatic breast cancer: a population-based evaluation.
BACKGROUND
A randomized controlled trial showed longer overall survival (OS) with docetaxel compared with paclitaxel in metastatic breast cancer patients with prior exposure to anthracycline. We report a similar comparison using population-based data.


METHODS
Data on patients treated with single-agent paclitaxel or docetaxel were retrospectively reviewed. OS was compared using a two-tailed log-rank test and expressed as Kaplan-Meier plots. A cost-effectiveness analysis was carried out using cost/patient and OS.


RESULTS
Four hundred and thirty-five patients met eligibility criteria. Prognostic factors were balanced between docetaxel and paclitaxel groups. Median OS was significantly longer for docetaxel versus paclitaxel [10.9 versus 8.3 months; hazard ratio 0.76; 95% confidence interval (CI), 0.62-0.92; P = 0.006]. The median number of cycles administered were four (docetaxel) and three (paclitaxel). The incremental cost-effectiveness ratio was $2434/per month of median survival gained. In the sensitivity analysis, the results were robust except that paclitaxel dominated when the low end of the 95% CI of survival for docetaxel was compared with the high end for paclitaxel.


CONCLUSIONS
This population-based study corroborated the randomized trial's conclusion that for patients with metastatic breast cancer, docetaxel provided superior survival compared with paclitaxel. Each additional month of survival had an incremental cost of $2434.
Vu
T
T
Provincial Systemic Therapy Program, BC Cancer Agency, Vancouver, British Columbia, Canada.
Ellard
S
S
Speers
C H
CH
Taylor
S C M
SC
de Lemos
M L
ML
Hu
F
F
Kuik
K
K
Olivotto
I A
IA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000401:mortality*; D001955:British Columbia / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D000077143:Docetaxel; D016527:Drug Costs; D005260:Female; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000191:economics* / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel