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Prepared by Millikan, Inc., NY Kate Fitch, RN, Med Principal and Healthcare Management Consultant Bruce Person, FSA, MAYA Principal and Consulting Actuary Commissioned by Innocent Oncology, a subsidiary

Drug Benefit for Chemotherapy Cancer Prevention Research Drug Interactions for Chemotherapy Clinical Trials and Benefits Cost/Quality-of-Life in Chemotherapy Patient Benefits Summary of Clinical Trial Results References BACKGROUND ON CHEMOTHERAPY TREATMENT IN CANCER Although more specific guidelines regarding chemo-therapy are available, no definitive guidelines exist regarding the specific treatments needed in patients diagnosed with locally advanced or metastatic non–Small Cell Lymphoma. The only guidelines available to physicians and other healthcare providers are published in the American Cancer Society's “Evidence-Based Chemotherapy Guidelines.”1 The consensus cancer drug therapy of the American Cancer Society (ACS) is for 1) highly active antiandrogen (TNA) with or without aromatize inhibitors; and 2) high-dose combination chemotherapy (with or without an adjuvant agent) in patients with metastatic non-Small Cell Lung Cancer who do not have disease progression or relapse.1–2 The ACS “Evidence-based Chemotherapy Guidelines” are based on the use of cytotoxic and other treatments as a combination with chemo or chemo plus other agents for patients with locally advanced or metastatic NS CLC who do not previously respond to either cytotoxic or other treatment; or have anemia, hyperpigmentation, or thrombocytopenia with no underlying disease other than NS CLC (e.g., leukemia, lymphoma).[1][3] Evidence-based chemo therapies generally include chemotherapy that has been proven to improve survival (i.e., cure).3–7 However, for newly diagnosed patients, chemo alone may not be sufficient to cure the patient by the time all other therapy options in the protocol have been exhausted. In the face of these options patients should be treated according to the ACS “Evidence-Based Chemotherapy Guidelines.”1 In general, chemotherapy is the only treatment for patients with low-grade NS CLC (i.e., the clinical characteristics of which are similar to that of highly aggressive NS CLC), regardless of stage. Patients with highly aggressive tumors (that has progressed beyond stage III) may receive cytotoxic chemotherapy in addition to or instead of other chemo. The ACS recommends the use of high-dose-combination chemotherapy for patients who have not previously responded to combination treatment with another agent.8 The ACS uses the terms “chemosumon” and “chemotherapy” interchangeably.

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