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.
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.
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).
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.
Expert review of pharmacoeconomics & outcomes research. 2018 Nov 10 [Epub ahead of print]
G Tsironis, K Koutsoukos, K Athanasakis, A Tsiara, K Tzannis, M Gerolympou, A Visvikis, G Oikonomopoulos, A Kollia, E Giannopoulou, M Dimitra, E Kostouros, A Papatsoris, A Dellis, K Stravodimos, I Varkarakis, E Samantas, G Aravantinos, N Kentepozidis, C Christodoulou, V Bozionelou, M A Dimopoulos, A Bamias
a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece., c Department of Health Economics , National School of Public Health , Athens , Greece ., b Hellenic Genito-Urinary Cancer Group ., d 3rd Oncology Clinic , General Oncology Hospital of Kifisias "Ag. Anargyroi" , Athens , Greece., e 2nd Oncology Clinic , Metropolitan Hospital , Piraeus , Greece., i 2nd Oncology Clinic , General Oncology Hospital of Kifisias "Ag. Anargyroi" , Athens , Greece., j Department of Medical Oncology , 251 Airforce General Hospital , Athens , Greece., k Department of Medical Oncology , University Hospital of Heraklion , Heraklion , Greece.