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: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalClinical Pharmacology and Therapeutics
Volume102
Issue number1
DOIs
Publication statusPublished - Jul 1 2017

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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