Optimizing treatment for patients with metastatic renal cell carcinoma in the central and Eastern European region

Vrdoljak, Eduard; Ciuleanu, Tudor-Eliade; Харкевич, Г. Ю.; Mardiak, Jozef; Mego, Michal; Padrik, Peeter; Petruželka, Luboš; Purkalne, Gunta; Shparyk, Yaroslav; Škrbinc, Breda; Szczylik, Cezary; Torday, Laszlo

doi:10.1517/14656566.2012.647406

Cited by 15 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[12] The reasons for the high RCC incidence in the region are not fully understood but may be related in part to external risk factors. [7] At present, the main aim of treatment in advanced RCC/ metastatic RCC (mRCC) is to extend both progression-free survival (PFS) and overall survival (OS) with the fewest adverse events (AEs) while maintaining the best possible quality of life (QoL). [13,14] In the past decade, the introduction of targeted agents has dramatically improved the PFS and OS of patients with mRCC compared with that observed during the cytokine era; such improvements suggest that it may be possible to convert mRCC into a chronic disease in some cases.…”

Section: Expert Opinionmentioning

confidence: 99%

“…One method to determine whether a treatment is economically feasible is to assess the number of total life-years and quality-adjusted life-years gained. [7] Using this method, second-line sorafenib was shown to be more cost-effective than best supportive care. [54] By contrast, the use of second-line everolimus was deemed not to be cost-effective compared with best supportive care.…”

Section: Requirements For Health Economic Datamentioning

confidence: 99%

“…[6] Economies in the CEE region are transitioning: gross domestic product per capita in CEE countries ranges from 1.2-to 9.1-fold lower than the EU's Big 5 (France, Germany, Italy, Spain and the UK). [7,8] To further compound the high rates of cancer mortality, healthcare expenditure per capita in CEE countries is considerably lower -ranging from 607.6 USD in Kazakhstan to 2046 USD in the Czech Republic -than in the EU's Big 5, where it ranges from 3040.1 to 4617 USD. [9] Renal cell carcinoma (RCC) accounts for~90% of kidney malignancies and 2 -3% of all adult malignancies.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Vrdoljak

Torday

Szczylik

et al. 2015

Expert Opinion on Pharmacotherapy

View full text Add to dashboard Cite

Introduction:The incidence and mortality rates of kidney cancer in the Central and Eastern European (CEE) region are among the highest in the world. Access to second and subsequent lines of metastatic renal cell carcinoma (mRCC) therapies is highly varied in the region. Despite the increasing body of evidence supporting the clinical benefit of multiple lines of treatment, access to treatment beyond first line is restricted in many of these countries. Areas covered: The adoption of targeted therapies for the first-line treatment of mRCC in the region was slow and faced many obstacles. In order to evaluate the current status of treatment beyond the first-line setting in the CEE region, this review examines the availability and reimbursement of mRCC drugs and clinical practice in institutions that treat patients with mRCC. Expert opinion: This review highlights the need to raise awareness among physicians, payers and regulators on clinical trial and cost-effectiveness data regarding the treatment of mRCC beyond the first line. The obstacles to mRCC drug access highlighted in this review need to be overcome to ensure that patients are receiving the best treatment available.

show abstract

Section: Expert Opinionmentioning

confidence: 99%

Section: Requirements For Health Economic Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Vrdoljak

Torday

Szczylik

et al. 2015

Expert Opinion on Pharmacotherapy

View full text Add to dashboard Cite

show abstract

“…Management of RCC is usually initiated with partial or radical nephrectomy. Ablation procedure is alternative for small renal masses in patients who are ineligible for surgery [ 10 , 11 ]. Adjuvant therapy has no proven efficacy on management of RCC.…”

Section: Introductionmentioning

confidence: 99%

Insulin-like growth factor-1 signaling in renal cell carcinoma

Tracz

Szczylik²,

Porta

et al. 2016

BMC Cancer

Self Cite

View full text Add to dashboard Cite

Renal cell carcinoma (RCC) incidence is highest in highly developed countries and it is the seventh most common neoplasm diagnosed. RCC management include nephrectomy and targeted therapies. Type 1 insulin-like growth factor (IGF-1) pathway plays an important role in cell proliferation and apoptosis resistance. IGF-1 and insulin share overlapping downstream signaling pathways in normal and cancer cells. IGF-1 receptor (IGF1R) stimulation may promote malignant transformation promoting cell proliferation, dedifferentiation and inhibiting apoptosis. Clear cell renal cell carcinoma (ccRCC) patients with IGF1R overexpression have 70 % increased risk of death compared to patients who had tumors without IGF1R expression. IGF1R signaling deregulation may results in p53, WT, BRCA1, VHL loss of function. RCC cells with high expression of IGF1R are more resistant to chemotherapy than cells with low expression. Silencing of IGF1R increase the chemosensitivity of ccRCC cells and the effect is greater in VHL mutated cells. Understanding the role of IGF-1 signaling pathway in RCC may result in development of new targeted therapeutic interventions. First preclinical attempts with anti-IGF-1R monoclonal antibodies or fragment antigen-binding (Fab) fragments alone or in combination with an mTOR inhibitor were shown to inhibit in vitro growth and reduced the number of colonies formed by of RCC cells.

show abstract

“…To make improvements, the most important, applicable way is to better organise the medical oncology, and to prevent overspending for procedures that are not necessary. The appropriate guidelines for follow-up in transitional countries are relatively more important than in developed countries, due to generally less investment in medicine, particularly in oncology (Vrdoljak et al 2011(Vrdoljak et al , 2012. Savings on costs resulting from non-essential follow-up procedures could be redirected to the primary and secondary cancer prevention as well as anticancer therapies with the proven impact on improving cancer survival.…”

Section: Discussionmentioning

confidence: 99%

Optimisation of breast cancer patients' follow-up - potential way to improve cancer care in transitional countries

et al. 2016

View full text Add to dashboard Cite

The aim of this analysis was to evaluate adherence of Croatian oncologists to follow-up criteria as suggested by the current national and international guidelines for women with breast cancer receiving adjuvant endocrine therapy. The use of clinical and diagnostic methods was documented in this prospective, non-interventional, multicenter study. A total of 438 post-menopausal patients receiving adjuvant endocrine treatment with non-steroidal aromatase inhibitors were included. Average annual frequency for each clinical and diagnostic method was calculated. Median adjuvant endocrine treatment duration before study recruitment was 10.5 months (interquartile 4.7-26.6). Patients were followed up for an average 23.5 ± 4.9 months. Average number of oncological visits was 5.3. Mammograms were performed at mean annual frequency of 0.7, chest radiographs at 0.5, abdominal ultrasounds at 0.9, breast ultrasounds at 1.2, complete blood counts and chemistry panels at 1.7, carcinoembryonic antigen at 0.8, cancer antigen 15-3 at 1.6, gynaecological examination at 0.3, and densitometry at mean annual frequency of 0.3. In conclusion, among post-menopausal women with breast cancer receiving adjuvant endocrine therapy in this study, more unnecessary and unproven follow-up procedures were done compared to the guidelines' recommendations.

show abstract

Optimizing treatment for patients with metastatic renal cell carcinoma in the central and Eastern European region

Cited by 15 publications

References 37 publications

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Insulin-like growth factor-1 signaling in renal cell carcinoma

Optimisation of breast cancer patients' follow-up - potential way to improve cancer care in transitional countries

Contact Info

Product

Resources

About