BackgroundNivolumab is a human monoclonal antibody against the programmed death-1 receptor (PD-1) that prevents inactivation of T lymphocytes.PurposeTo assess the efficacy and safety of nivolumab in squamous non-small cell lung cancer (NSCLC).Material and methodsThis was a retrospective descriptive study of patients with squamous NSCLC who were treated with nivolumab from November 2015 to August 2016. The dose of nivolumab administered was 3 mg/kg as an intravenous infusion every 2 weeks and all patients were premedicated with granisetron 1 mg intravenously. Overall survival (OS) was considered as a measure of efficacy, obtained by the Kaplan–Meier method and defined as the time elapsed from the start of the treatment until the patient died, excluding those patients who had not died at the end of the study.Results8 patients (6 men and 2 women) were included, all with stages IIIa-b and IV, who were ex-smokers, except for 1 patient who still smoked 4 cigarettes/day. Only 1 patient had brain metastases at baseline. Mean age was 64±12 years and mean pre-nivolumab lines of chemotherapy were 2.12±1.35. Regarding the functional status of patients, 4 had an ECOG of 2 and the remaining 4 patients had an ECOG of 0 or 1. 2 patients died during the study period. Brain metastases were evidenced in 1 patient due to nivolumab progression. The other 5 patients remained stable. Median OS was 5 months (95% CI 3.56–6.43). Regarding safety profile, most patients reported asthenia, muscle weakness, loss of appetite and/or cough. However, in none of the cases did this result in suspension or delay of treatment.ConclusionThe median OS obtained in our study was lower than that published in the CheckMate 017 study (5 vs 9.2 months), with an acceptable safety profile. However, it should be considered that in our case, 4 patients had an ECOG of 2, whereas in the CheckMate 017 study all patients had an ECOG of 0 or 1 (20% and 79%, respectively) which, together with the small sample size, can justify the results obtained.References and/or acknowledgementsBrahmer J, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med 2015;0:1–13.No conflict of interest

(median 20 per centre). The composite indexes of physical and mental well being were correlated with each other (R=0.826; p<0.001) according to a direct proportionality, and both had an inverse correlation with the degree of EDSS disability (R=À0.511, p<0.001 and R=0.344, p<0.001, respectively). Although there was no correlation between QoL and route of administration of the drug, we found significantly lower scores for patients treated with teriflunomide compared with other oral drugs (54.24 points vs 67.64 for fingolimod and 78.25 for dimethyl-fumarate; p=0.002). Conclusion and relevance The study achieved primary and secondary endpoints and indicated a relevant decrease in QoL related to physical health associated with teriflunomide, which deserves further investigations. We also demonstrated that joint action by a scientific society and a student association was a valuable method to perform a no profit, multicentre, observational study in real practice.

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Introduction Due to their impact on healthcare systems, the sustainability and optimization of high-cost drugs is an issue of concern for several countries. Different strategies have been implemented such as centralized purchasing to optimize budgetary resources. However, there is still a need for a mechanism to optimize these drugs further. Methods We conducted this prospective multicenter intervention study in five hospitals in the Andalusian Public Health System of Cádiz (Spain) between July 2019 and September 2021. We developed an online website (Farmastock) and implemented it to determine the availability of high-cost, low-use, and near-expiry medicines in each hospital. We used a simple analysis using operational variables to assess the project intervention's savings impact on managing these high-cost drugs. ResultsThe implementation of Farmastock in Cádiz resulted in savings of 675,757.52 € for the Andalusian Public Health System, with 238 medicines transferred out of the 373 available. Of these medicines offered, the most considerable percentage were medicines used for pathologies with high clinical instability and accounted for nearly 80% of the medicines optimized by the tool. Conclusions Farmastock allowed the Andalusian Public Health System to make substantial financial savings by not making new purchases of high-cost drugs available in other centers of this health network that were not being used. Therefore, this tool is a very efficient measure to contribute to the sustainability of the APHS and could be implemented in more hospitals soon.