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Colorectal Cancer Case Studies

Charles Fuchs, MD: Cost Issues With CT Regimens and Bevacizumab

Charles Fuchs, MD
Published Online:Apr 28, 2016
Case 2 examines a 52-year-old woman newly diagnosed with metastatic CRC who is genotyped as part of her initial work up.

Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 2

Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 1
Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 2
Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 1
Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 2


Finally, could you briefly discuss some of the cost issues associated with adding biologics to CT? How does the cost of bevacizumab compare with that of cetuximab? Given the outcome of the CALGB/SWOG 80405 study, what do you think is a cost-effective approach to using these agents?

There was a cost-effective analysis looking at CALGB 80405 which did the comparison of chemotherapy with bevacizumab, as opposed to chemotherapy plus cetuximab. That result suggested that perhaps bevacizumab was more cost effective than cetuximab. At the moment I think we as practicing oncologists are not bound to make our treatment decisions exclusively on cost. What I'm pleased to say is that we can often make those decisions based on what is really the optimal care for that specific patient, recognizing that we have to be mindful of cost considerations and ultimately I suspect our treatment paradigms will start to take that into account.

At the moment, I think it's reasonable to use either bevacizumab or an EGFR antibody, realizing that that cost analysis suggests that bevacizumab may be somewhat more cost effective.

Unresectable Colon Cancer: Case 2

52-year-old woman newly diagnosed with metastatic CRC and is genotyped as part of her initial work up.

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