Presentation (CTI)

OBJECTIVES: Carboplatin plus paclitaxel (CarboTaxol), a common chemotherapeutic combination, frequently causes neutropenia, leukopenia and febrile neutropenia. These adverse events reduce patients’ quality of life, increase caregiver burden and healthcare costs. Genetic variability influences individual susceptibility to these adverse events. This study assessed the early cost-utility of Multiplex Cell Culture Technology (MCCT), which is not currently used clinically but enables genetic analysis of many individuals simultaneously and can be performed before CarboTaxol treatment to identify high-risk patients for prophylactic treatment and improve palliative care.
METHODS: A cost-utility analysis compared MCCT-guided intervention with standard care, estimating incremental costs and QALYs gained. The literature was reviewed to identify the costs, disutilities, duration and proportion of patients experiencing serious (grade ≥3) CarboTaxol-induced neutropenia, leukopenia, and febrile neutropenia. MCCT test costs were derived from in-house estimates based on cell culture and genetic analysis costs, and varied in sensitivity analyses to assess robustness.
RESULTS: Standard care to manage serious adverse events of CarboTaxol costs an average of approximately €1,556 per patient and results in a loss of 0.002 QALYs. In the base-case scenario (MCCT test cost: €800), the MCCT test strategy could reduce costs to €1,193 (cost-savings: €363) and improve health (+0.002 QALYs). A 20% higher MCCT test cost (€960) reduced savings to €203 (total cost: €1,353), whereas a 20% lower MCCT test cost (€640) increased savings to €423 (total cost: €1,033).
CONCLUSIONS: CarboTaxol treatment is widely used for various cancers, especially ovarian cancer, and frequently causes serious neutropenia, febrile neutropenia and leukopenia. This early cost-utility analysis shows that using the MCCT test to guide prophylactic treatment can improve health outcomes and reduce costs by identifying high-risk patients and enabling targeted prevention. Further studies should focus on validating the predictive accuracy of the MCCT test to determine its reliability in identifying high-risk patients.