Optimal Allocation of Chemotherapy Schemes for Metastatic Colon Cancer in Colombia

Area of Science:

• Oncology
• Health Economics
• Mathematical Modeling

Background:

• Metastatic colorectal cancer (mCRC) treatment in Colombia requires optimized chemotherapy regimens.
• Current chemotherapy proportions may not maximize patient outcomes, specifically quality-adjusted life-years (QALYs).

Purpose of the Study:

• To determine the optimal proportions of different chemotherapy schemes for mCRC patients in Colombia.
• To maximize QALYs using a linear programming model under various budget constraints.

Main Methods:

• A linear programming model was employed to identify optimal chemotherapy scheme proportions.
• The model incorporated parametric and dynamic optimization across six budget scenarios.
• Results were benchmarked against current chemotherapy mixture practices in Colombia.

Main Results:

• Optimal proportions identified: 63% FOLFOXIRI, 37% FOLFIRI, 0.8% FOLFIRI plus cetuximab, yielding 8734 QALYs.
• Scenario-dependent optimal schemes varied, with FOLFIRI favored in optimistic budgets and fluorouracil/leucovorin in pessimistic ones.
• Dynamic optimization indicated FOLFIRI and FOLFOX as cost-effective for maximizing QALYs within budget limits.

Conclusions:

• Current chemotherapy scheme utilization for mCRC in Colombia is suboptimal.
• Increased use of FOLFIRI, FOLFOX, and FOLFOXIRI is recommended for improved patient outcomes.
• Mathematical modeling provides a framework for optimizing cancer treatment regimens based on QALY maximization.