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Long‐term survival estimates for imatinib versus interferon‐α plus low‐dose cytarabine for patients with newly diagnosed chronic‐phase chronic myeloid leukemia
Author(s) -
Anstrom Kevin J.,
Reed Shelby D.,
Allen Andrew S.,
Glendenning G. Alastair,
Schulman Kevin A.
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20674
Subject(s) - medicine , imatinib , cytarabine , myeloid leukemia , chronic myelogenous leukemia , imatinib mesylate , survival analysis , survival rate , oncology , surgery , leukemia
Abstract BACKGROUND The authors estimated survival among patients with chronic myeloid leukemia for a cost‐effectiveness analysis of imatinib versus interferon‐α plus low‐dose cytarabine (IFN+LDAC). METHODS Two‐year survival and cytogenetic response were determined using data from 553 patients who received first‐line imatinib in the International Randomized Interferon versus ST571 Study (IRIS). Long‐term survival was modeled on complete cytogenetic response (CCyR) after 2 years. Long‐term survival for patients with a CCyR was modeled using data from a cohort study of 317 patients with CCyRs. Long‐term survival for patients without a CCyR was modeled using data from a trial of 275 patients who were treated with IFN+LDAC. Computation of lifetime survival estimates for imatinib assumed a proportional hazards relation between survival for an age‐matched and gender‐matched cohort and survival for patients with and without a CCyR. RESULTS For IRIS patients receiving imatinib, the estimated survival was 95.8% and the CCyR rate was 73.8%. The average residual life expectancy was estimated to be 16.71 years for CCyR patients and 5.78 years for non‐CCyR patients. The estimated life expectancy after treatment with imatinib was 15.30 years, compared with 9.07 years for patients who were treated with IFN+LDAC in previous studies. CONCLUSIONS Assuming the relation between CCyR and survival with interferon‐α holds for imatinib, higher CCyR rates with imatinib therapy will result in an estimated 6.23 life‐years gained compared with treatment with IFN+LDAC. Cancer 2004. © 2004 American Cancer Society.