Q-TWiST analysis of lapatinib combined with capecitabine for the treatment of metastatic breast cancer

B. Sherrill, M. M. Amonkar, S. Stein, M. Walker, C. Geyer, D. Cameron

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The addition of lapatinib (Tykerb/Tyverb) to capecitabine (Xeloda) delays disease progression more effectively than capecitabine monotherapy in women with previously treated HER2+ metastatic breast cancer (MBC). The quality-adjusted time without symptoms of disease or toxicity of treatment (Q-TWiST) method was used to compare treatments. The area under survival curves was partitioned into health states: toxicity (TOX), time without symptoms of disease progression or toxicity (TWiST), and relapse period until death or end of follow-up (REL). Average times spent in each state, weighted by utility, were derived and comparisons of Q-TWiST between groups performed with varying combinations of the utility weights. Utility weights of 0.5 for both TOX and REL, that is, counting 2 days of TOX or REL as 1 day of TWiST, resulted in a 7-week difference in quality-adjusted survival favouring combination therapy (P=0.0013). The Q-TWiST difference is clinically meaningful and was statistically significant across an entire matrix of possible utility weights. Results were robust in sensitivity analyses. An analysis with utilities based on EQ-5D scores was consistent with the above findings. Combination therapy of lapatinib with capecitabine resulted in greater quality-adjusted survival than capecitabine monotherapy in trastuzumab-refractory MBC patients.

Original languageEnglish (US)
Pages (from-to)711-715
Number of pages5
JournalBritish Journal of Cancer
Volume99
Issue number5
DOIs
StatePublished - Sep 2 2008

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Breast Neoplasms
Weights and Measures
Survival
Disease Progression
Therapeutics
Area Under Curve
lapatinib
Capecitabine
Recurrence
Health

Keywords

  • Breast cancer
  • Lapatinib
  • Q-TWiST
  • Quality-adjusted survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Q-TWiST analysis of lapatinib combined with capecitabine for the treatment of metastatic breast cancer. / Sherrill, B.; Amonkar, M. M.; Stein, S.; Walker, M.; Geyer, C.; Cameron, D.

In: British Journal of Cancer, Vol. 99, No. 5, 02.09.2008, p. 711-715.

Research output: Contribution to journalArticle

Sherrill, B, Amonkar, MM, Stein, S, Walker, M, Geyer, C & Cameron, D 2008, 'Q-TWiST analysis of lapatinib combined with capecitabine for the treatment of metastatic breast cancer', British Journal of Cancer, vol. 99, no. 5, pp. 711-715. https://doi.org/10.1038/sj.bjc.6604501
Sherrill, B. ; Amonkar, M. M. ; Stein, S. ; Walker, M. ; Geyer, C. ; Cameron, D. / Q-TWiST analysis of lapatinib combined with capecitabine for the treatment of metastatic breast cancer. In: British Journal of Cancer. 2008 ; Vol. 99, No. 5. pp. 711-715.
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