Projecting The Cost-Effectiveness Of Pertuzumab With Trastuzumab And Docetaxel In The Neoadjuvant Treatment Of Her2-Positive, Locally Advanced, Inflammatory Or Early Breast Cancer.

642 Background: The NeoSphere trial (Gianni et al. [2012]) compared the following regimens for neoadjuvant treatment in HER2+, locally advanced, inflammatory or early breast cancer: 1) trastuzumab and docetaxel (TH) 2) pertuzumab, trastuzumab and docetaxel (THP), 3) pertuzumab plus trastuzumab (HP), and 4) pertuzumab plus docetaxel (TP). The pathological complete response (pCR) rates were 29.0% for TH, 45.8% for THP, 16.8% for HP, and 24.0% for TP. THP significantly increased the pCR rate. We performed a cost-effectiveness analysis of THP compared to other treatment regimens in the neoadjuvant setting based on the pCR results from NeoSphere. Methods: We constructed a combined decision-analytic (decision tree) and partitioned survival (area under the curve) model with three health states: disease-free (DF), progressive disease (PD), and death. The decision tree modeled the probability of pCR and the partitioned survival model projected life expectancy of patients who did or did not achieve pCR. Utility dat...