Use of targeted therapy in patients with metastatic renal cell carcinoma: clinical and economic impact in a Canadian real-life setting

Current oncology

N. Basappa¹  D. Heng²  N. Reaume³  C. Kollmansberger⁴  E. Lévesque⁵  S. Nazha⁶  S. Tanguay⁷  A. Kapoor⁸  L. Wood⁹  G. Bjarnason^1,10  M. Jewett^1,11  D. Soulières^1,12 

[1] Centre Hospitalier Universitaire de Québec, University of Laval;Centre Hospitalier de l’Université de Montréal, University of Montreal;Cross Cancer Institute, University of Alberta;Dalhousie University, Queen Elizabeth II Health Sciences Centre;McGill University Health Center;McGill University Health Centre;McMaster University;Princess Margaret Cancer Centre;Sunnybrook Hospital, University of Toronto;Tom Baker Cancer Center, University of Calgary;University of British Columbia;University of Ottawa

关键词: Renal cell carcinoma;    targeted therapy;    effectiveness;    safety;    real-world data;   

DOI  :  10.3747/co.25.4103

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

IntroductionOutside of randomized controlled clinical trials, the understanding of the effectiveness and costs associated with targeted therapies for metastatic renal cell carcinoma (mrcc) is limited in Canada. The purpose of the present study was to use real-world prospective data to assess the effectiveness and cost of targeted therapies for patients with mrcc. MethodsThe Canadian Kidney Cancer Information System, a pan-Canadian database, was used to identify prospectively collected data relating to patients with mrcc. First- and subsequent-line time to treatment termination (ttt) was determined from therapy initiation time (sunitinib or pazopanib) to discontinuation of therapy. Kaplan–Meier survival curves were used to estimate the unadjusted and adjusted overall survival (os) by treatment. Unit treatment cost was used to estimate the cost by line of treatment and the total cost of therapy for the management of patients with mrcc. ResultsThe study included 475 patients receiving sunitinib or pazopanib in the first-line setting. Patients were treated mostly with sunitinib (81%); 19% of patients were treated with pazopanib. The median ttt in the first line was 7.7 months for patients receiving sunitinib and 4.6 months for those receiving pazopanib ( p< 0.001). The adjusted os was 32 months with sunitinib and 21 months with pazopanib (hazard ratio: 1.61;p< 0.01). The total median cost of first- and second-line treatments was $56,476 (interquartile range: $23,738–$130,447) for patients in the sunitinib group and $46,251 (interquartile range: $28,167–$91,394) for those in the pazopanib group. ConclusionsFor the two therapies, os differed significantly, with a higher median os being observed in the sunitinib group. The cost of treatment was higher in the sunitinib group, which is to be expected with longer survival.

【 授权许可】

Unknown