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Letter to Editor
Therefore, the patients of breast cancer on tamoxifen
therapy should be followed‑up for a longer period.
Endometrial thickness is the main indicator to monitor
the progress of carcinoma endometrium, hence regular
TVS is indicated during follow up and if the thickness
observed more than 8.0 mm than all the diagnostic
measures should be considered. In summary, the risk of
endometrial cancer increases following tamoxifen therapy
for invasive breast cancer; however, the net benefit of
adjuvant tamoxifen therapy greatly outweighs the risk of
developing endometrial cancer.[2]
2.
3.
4.
Anil Kumar Dhull, Vivek Kaushal, Sunita Singh1,
Rajeev Sen1
Gynecol 1996;39:629‑40.
Chauhan AK, Dhull AK, Singh H. Carcinoma Endometrium. Obstet
Gynecol Today 2008;13:165‑71.
Kleinman D, Karas M, Danilenko M, Arbell A, Roberts CT,
LeRoith D, et al. Stimulation of endometrial cancer cell growth
by tamoxifen is associated with increased insulin‑like growth
factor (IGF)‑I induced tyrosine phosphorylation and reduction
in IGF binding proteins. Endocrinology 1996;137:1089‑95.
Suh‑Burgmann EJ, Goodman A. Surveillance for endometrial
cancer in women receiving tamoxifen. Ann Intern Med
1999;131:127‑35.
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Departments of Radiation Oncology, Regional Cancer Centre,
1
Pathology, PGIMS Rohtak, Haryana, India
Correspondence to: Dr. Anil Kumar Dhull,
E‑mail: [email protected]
DOI:
10.4103/2278-330X.105867
References
1.
Website:
www.sajc.org
Barakat RR. Tamoxifen and endometrial neoplasia. Clin Obstet
Cost‑utility analysis of using
nimotuzumab in end‑stage
cancerous patient: Is it too
expensive?
Sir,
The use of new alternative cancer therapy for
end‑stage cancerous patient is interesting. Of several
new agents, nimotuzumab is an immunological‑based
cancer therapeutic agent. Nimotuzumab is widely
mentioned for its usefulness in management of
end‑stage cancerous patient.[1,2] The prolongation of life
expectation is mentioned as a usefulness of nimotuzumab
administration.[3] However, the main concern is its high
cost. Whether it is cost effectiveness is interesting.
Here, the authors present the experience in using
nimotuzumab in end‑stage cancerous patients (about
five cases). Based on our setting, the average cost for
nimotuzumab management of the cancerous patient for
a 3‑month period is about 450,000 baht (about 15,000
USD) and the average extended life span is only about
1.5 months. It can be seen that the cost utility is about
10,000 USD/1 month life span extension. Of interest, the
cost per utility is very expensive and this might not be
better than no nimotuzumab in term of life expectation
expansion (since the cases might have this prolonged life
span without use of any drug). Although the new drug
is effective but the great concern is on its high cost.
The use of this drug has to be carefully considered on
this fact.
Kamon Chaiyasit, Viroj Wiwanitkit1
Maefahlaung University Hospital, Bangkok, Thailand,
1
Hainan Medical University, China
Correspondence to: Dr. Kamon Chaiyasit,
E‑mail: [email protected]
References
1.
2.
3.
Li LF, Wang HQ, Liu XM, Zhang HL, Qiu LH, Qian ZZ, et al.
Nimotuzumab in combination with chemotherapy in patients
with advanced non‑small cell lung cancer. Zhonghua Zhong Liu
Za Zhi 2011;33:626‑8.
Bebb G, Smith C, Rorke S, Boland W, Nicacio L, Sukhoo R, et al.
Phase I clinical trial of the anti‑EGFR monoclonal antibody
nimotuzumab with concurrent external thoracic radiotherapy in
Canadian patients diagnosed with stage IIb, III or IV non‑small
cell lung cancer unsuitable for radical therapy. Cancer Chemother
Pharmacol 2011;67:837‑45.
Saurez G, Cabanas R, Zaldívar M, Garnier T, Iglesias B, Piedra P,
et al. Clinical experience with nimotuzumab in cuban pediatric
patients with brain tumors, 2005 to 2007. MEDICC Rev
2009;11:27‑33.
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Website:
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DOI:
10.4103/2278-330X.105873