Cost Benefit Analysis Of Laboratory Directed Chemotherapy For Advanced Pancreatic Cancer In Us And Brazilian Patients.

e17782 Background: Precision medicine offers improved response rates (RR) u0026 cost containment. Pancreatic cancer (PC) with Stage IV 5-yr survival of 1-2% is ideal for strategies that pre-select responsive patients (pts) yet actionable molecular targets are few. Phenotypic assays, with the capacity to examine cytotoxic u0026 targeted agents, the subject of prior meta-analysis (Apfel, Proc. ASCO, 2013), provided a 2.04 fold improvement in (RR) (p u003c 0.001) u0026 1.44 fold improvement in 1-yr survival (P = 0.02) in 2581 pts. Methods: We applied Ex Vivo Analysis of Programmed Cell Death (EVA/PCD) (Nagourney, Anticancer Res, 2012) in 23 US u0026 Brazilian pt. tumors to identify the most active drugs, then used literature (RR) of standard PC regimens u0026 hospital pharmacy charges/2 cycles ($ or $R/mg) @ 1.7 m2 (BSA) for predictions. Results: Drug selection frequency (N/%), RR (post-test) u0026 cost/2-cycles reveal: CDDP + Gemcitabine 4/23 (17.9%); RR = 40.8%; $534/R$ 5748; FOLFIRINOX 8/23(37.7%) RR = 63.4%, $2988/R$27,592; GTX 2/2...