Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Dr. Greg Zaric


Glioblastoma Multiforme (GBM), a glioma – cancer of the brain’s glial cells – is the most common and deadly malignant primary central nervous system tumor in developed countries. Two recently completed clinical trials investigating the use of bevacizumab (BEV), a monoclonal antibody, to treat newly diagnosed GBM concomitant with the standard-of-care (SOC) showed mixed survival and quality of life outcomes. In this study, a cost utility study was conducted to investigate if BEV should be used to treat newly diagnosed GBM. A three stage time-dependent Markov model was built using survival estimates from the two clinical trials, costs from Ontario residents diagnosed with GBM between 2003 and 2011, and literature utility values. The expected incremental cost utility ratio for BEV plus the SOC compared to the SOC alone is 8,393,212 $/quality adjusted life year over a six year period. Therefore, BEV plus the SOC is not cost effective as a first-line therapy.