Maintenance Treatment with Interferon in Multiple Myeloma
- 10 Downloads
Some clinical trials have shown that long-term treatment with alpha interferon (IFN) in patients with multiple myeloma can improve survival in comparison with patients not given IFN, but other studies have found no survival benefit in patients treated with IFN. We utilised the clinical material reported in these trials to conduct a meta-analysis on long-term survival. The survival curves published in each of these studies were analysed to determine the mean lifetime survival (MLS) for treated patients and controls using Gompertz’ extrapolation to infinity of the survival curves. Values of MLS were then pooled using standard meta-analytic techniques. Our meta-analysis showed that maintenance treatment with IFN did not improve MLS at levels of statistical significance. The MLS was 3.9 years per patient in the IFN group versus 3.4 years per patient in the controls (p = 0.095). Because the level of statistical significance was borderline, a lifetime cost-effectiveness analysis was undertaken to determine the cost per life-year gained using IFN. This cost was found to be around $US84 000 per life-year gained, a value suggesting an unfavourable pharmacoeconomic profile. We conclude that the survival advantage of maintenance treatment with IFN in myeloma patients, if any, has a small clinical relevance and demonstrates an intermediate or unfavourable pharmacoeconomic ranking.
KeywordsMultiple Myeloma Root Mean Square Error Adis International Limited Drug Invest Myeloma Patient
Unable to display preview. Download preview PDF.
- 5.Salmon ES, Crowley JJ, Grogon TM, et al. Combination chemotherapy, glucocorticoids, and interferon alfa in the treatment of multiple myeloma: a Southwest Oncology Group study. J Clin Oncol 1994; 11: 2405–14Google Scholar
- 6.Peest D, Deicher H, Leo R, et al. A comparison of polychemotherapy and melphalan/prednisone for primary remission induction, and interferon alpha for maintenance treatment, in multiple myeloma. A prospective trial of the German myeloma treatment group. Eur J Cancer 1995; 31: 146–51CrossRefGoogle Scholar
- 14.Varoli G. Matematica Finanziaria. Patron, Bologna, 1990: 72–5Google Scholar
- 15.Lee ET. Statistical methods for survival data analysis. Belmont, CA: Lifetime Learning, 1980: 50–3Google Scholar
- 20.Hjorth M and the Nordic Myeloma Study Group. Interferon alfa-2b added to melphalan-prednisone for initial and maintenance therapy in multiple myeloma. Ann Intern Med 1996; 124: 212–22Google Scholar