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 Rev Pharmacoecon Outcomes Res. 2019 Aug;19(4):491-501. doi: 10.1080/14737167.2019.1546121. Epub 2018 Nov 19.

Abstract

Background:Metastatic RCC (mRCC) treatment has been revolutionized with 11 approved targeted agents. We report patterns of practice, outcomes and pharmacoeconomic analyses after the introduction of targeted therapy. Patients and methods: CRISIS was a retrospective multicenter study of mRCCpatients who received targeted therapy . Results were related to the start of 1st-line therapy, with a cut off at 1 January 2011 in order to depict the impact of increased availability of effective options. Results: 164 patients, were included. 70.1% and 44.5% received 2nd and 3rd-line therapy, respectively. More patients were treated in 2nd-line after 1 January 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. The mean total cost/patient was 35,012.2 Euros (standard deviation [SD]: 28,971.5). Conclusions: Our study confirms previous real-world data suggesting that continuing advances in the treatment of mRCC produce favorable outcomes in everyday practice. Pharmacoeconomic analyses are important for cost-effective utilization of emerging novel therapies.

Keywords: Greece; Hellenic Genitourinary Cancer Group-HGUCG; metastatic RCC; pharmacoeconomic analysis; targeted therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / economics
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / economics
  • Cost-Benefit Analysis
  • Disease-Free Survival
  • Economics, Pharmaceutical*
  • Female
  • Follow-Up Studies
  • Greece
  • Humans
  • Indazoles
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / economics
  • Male
  • Middle Aged
  • Molecular Targeted Therapy / economics
  • Molecular Targeted Therapy / methods*
  • Neoplasm Metastasis
  • Practice Patterns, Physicians' / statistics & numerical data
  • Pyrimidines / administration & dosage
  • Pyrimidines / economics
  • Retrospective Studies
  • Sulfonamides / administration & dosage
  • Sulfonamides / economics
  • Sunitinib / administration & dosage
  • Sunitinib / economics
  • Survival Rate

Substances

  • Antineoplastic Agents
  • Indazoles
  • Pyrimidines
  • Sulfonamides
  • pazopanib
  • Sunitinib