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Patterns of practice and pharmacoeconomic analysis of the management of patients with metastatic renal cell carcinoma (mRCC) in Greece - the CRISIS study. A retrospective analysis by the Hellenic Genitourinary Cancer Group (HGUCG).
Expert Review of Pharmacoeconomics & Outcomes Research 2018 November 11
BACKGROUND: The treatment of Metastatic RCC (mRCC) is mainly systematic and has been revolutionized the last years with 11 approved targeted agents. We report patterns of practice, outcomes and pharmacoeconomic analyses after the approval of the first targeted agent.
PATIENTS AND METHODS: CRISIS was a retrospective multicenter study reviewing the medical charts of adult patients with histologically or cytologically confirmed mRCC that have received or started 1st-line therapy with any of the approved targeted agents. Results were reported in relation to the date of start of 1st-line therapy, with a cut off at 1/JAN/2011 in order to depict the impact of increased availability of effective options in mRCC.
RESULTS: 164 patients, treated with first-line therapy from June 2006 to September 2016, were included. 70.1% and 44.5% received 2nd and 3rd-line therapy, respectively. More patients were treated in 2nd -line after 1/JAN/2011. After a median follow up of 55.1 months, median progression-free (PFS) and overall survival (OS) were 10.7 (95% confidence intervals [CI]: 8.3-13.7), 7.3 (95% CI: 5.1-8.6), 5.8 (95% CI: 3.8-7.8) and 34 (95% CI: 28.5-39.8), 22.4 (95% CI: 16-32.1), 18.3 (95% CI: 12.4-26.4) months for first, second and third line, respectively. Efficacy of sunitinib and pazopanib in 1st -line were similar, while expected toxicity profiles of sunitinib, pazopanib and everolimus were observed. The mean total cost/patient was 35,012.2 Euros (standard deviation [SD]: 28,971.5).
CONCLUSIONS: Acknowledging the limitations of a retrospective analysis, our study confirms previous real-world evidence suggesting that continuing advances in the treatment of mRCC has led to improved outcomes in everyday practice worldwide. Pharmacoeconomic analyses are important for cost effective utilization of emerging novel therapies.
PATIENTS AND METHODS: CRISIS was a retrospective multicenter study reviewing the medical charts of adult patients with histologically or cytologically confirmed mRCC that have received or started 1st-line therapy with any of the approved targeted agents. Results were reported in relation to the date of start of 1st-line therapy, with a cut off at 1/JAN/2011 in order to depict the impact of increased availability of effective options in mRCC.
RESULTS: 164 patients, treated with first-line therapy from June 2006 to September 2016, were included. 70.1% and 44.5% received 2nd and 3rd-line therapy, respectively. More patients were treated in 2nd -line after 1/JAN/2011. After a median follow up of 55.1 months, median progression-free (PFS) and overall survival (OS) were 10.7 (95% confidence intervals [CI]: 8.3-13.7), 7.3 (95% CI: 5.1-8.6), 5.8 (95% CI: 3.8-7.8) and 34 (95% CI: 28.5-39.8), 22.4 (95% CI: 16-32.1), 18.3 (95% CI: 12.4-26.4) months for first, second and third line, respectively. Efficacy of sunitinib and pazopanib in 1st -line were similar, while expected toxicity profiles of sunitinib, pazopanib and everolimus were observed. The mean total cost/patient was 35,012.2 Euros (standard deviation [SD]: 28,971.5).
CONCLUSIONS: Acknowledging the limitations of a retrospective analysis, our study confirms previous real-world evidence suggesting that continuing advances in the treatment of mRCC has led to improved outcomes in everyday practice worldwide. Pharmacoeconomic analyses are important for cost effective utilization of emerging novel therapies.
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