Abstract:
INTRODUCTION:The introduction of active new agents, such as small molecules and checkpoint inhibitors, for the treatment of metastatic renal-cell cancer (mRCC) is associated with a relevant increase in costs, and it is therefore important to strike a balance between the costs of treatment and the added value represented by the improvement of the clinical parameters of interest such as progression-free survival (PFS) and overall survival (OS). METHODS:This analysis was conducted to assess the pharmacologic costs of second-line treatments for mRCC and was restricted to pivotal phase 3 randomized controlled trials (RCTs) used as second-line therapy. RESULTS:Our analysis evaluated 4 phase 3 RCTs including a total of 2454 patients. The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) reached high scores (grade 5) for the CheckMate 025 trial, medium scores (grade 3) for the RECORD-1 and AXIS trials, and low scores (grade 2) for the INTORSECT trial. When we combined the costs of therapy with the measure of efficacy represented by the PFS and OS, we found that the most relevant increase of costs was associated with the use of nivolumab but that it differed according to the difference in costs in terms of life gained, with the highest costs per week of PFS gained (€11,960) but the lowest cost for month of OS gain (€1772). CONCLUSION:When pharmacologic costs of drugs are combined with the measure of efficacy represented by the OS, nivolumab is a cost-effective second-line treatment for patients with mRCC.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Giuliani J,Bonetti Adoi
10.1016/j.clgc.2018.02.006subject
Has Abstractpub_date
2018-06-01 00:00:00pages
e557-e562issue
3eissn
1558-7673issn
1938-0682pii
S1558-7673(18)30122-8journal_volume
16pub_type
杂志文章abstract:BACKGROUND:Everolimus is an approved agent for use after disease progression with vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) in patients with metastatic renal cell carcinoma. With recently published trials showing efficacy of nivolumab and cabozantinib in the second-line therapy...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.011
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Enzalutamide is active in advanced castration-resistant prostate cancer (CRPC) patients, in whom it has shown to be able to increase survival. We report the enzalutamide effect on primary prostate tumors, assessed by changes of metabolic tumor activity detected by (18)F-fluorocholine-positron emission tomogr...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.03.004
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:Pelvic lymph node dissection (PLND) is not recommended for low-risk prostate cancer (PCa) patients. However, the rate of PLND in this population is unknown. METHODS:We queried the National Cancer Data Base for PCa patients who underwent robot-assisted radical prostatectomy from 2010 to 2013 and stratified...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.05.013
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The objective of this study was to evaluate differences in tolerability in patients with metastatic castration-resistant prostate cancer treated with enzalutamide (ENZA) or abiraterone acetate plus prednisone (AA+P). PATIENTS AND METHODS:This was a phase IV, prospective, open-label, multicenter, real-world ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.07.017
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:Anemia is a common morbidity of advanced prostate cancer, and prostate cancer treatment and has been associated with a worse overall survival and reduced quality of life in patients with prostate cancer. We sought to determine if infrequent dosing of darbepoetin alfa is safe and effective in treating anemia in ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.012
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The complete remission (CR) rate with salvage systemic therapy for urothelial carcinoma (UC) is unclear, and its value as an intermediate end point and association with survival are unknown. MATERIALS AND METHODS:Data from phase II trials of salvage chemotherapy and/or biologic agents were pooled. Data rega...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.09.004
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:We investigated the serum proteome of hormone-sensitive prostate cancer patients to determine candidate biomarkers associated with androgen deprivation therapy (ADT) efficacy. PATIENTS AND METHODS:Serum proteomes generated using isobaric mass tags for relative and absolute quantitation were analyzed using r...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.03.006
更新日期:2019-08-01 00:00:00
abstract:INTRODUCTION:Clinical T1 (cT1) bladder cancer is associated with high rates of recurrence, upstaging, and progression. Guidelines recommend that these patients be treated with adjuvant intravesical Bacillus Calmette-Guérin immunotherapy (BCG) or upfront radical cystectomy (RC). We analyzed the National Cancer Database ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.01.007
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Upper urinary tract urothelial carcinoma (UUTUC) is one of the uncommon malignancies lacking of prognostic indicators. Lactate dehydrogenase (LDH) has been demonstrated to correlate with clinical outcomes in human cancers. In this study, we aimed to evaluate the prognostic implication of the preoperative LDH...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.01.003
更新日期:2016-08-01 00:00:00
abstract::Recent phase III trial results have demonstrated the effectiveness of sipuleucel-T, a therapeutic cancer vaccine, in the treatment of metastatic prostate cancer. Yet, despite the survival benefit of sipuleucel-T, questions remain about how immunologic agents can be used in the treatment of metastatic prostate cancer. ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.3816/CGC.2010.n.002
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Myelosuppression is common in patients with progressive castration-resistant prostate cancer and bone metastases. Radium-223 prolongs overall survival in these patients but may cause myelosuppression; understanding risk factors will improve clinical decision making. We describe hematologic safety of radium-2...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clgc.2016.07.027
更新日期:2017-02-01 00:00:00
abstract::Nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) offers comparable oncologic results but a lower risk of chronic kidney disease when compared with radical nephrectomy; however it can result in positive surgical margins (PSMs) and consequently to a possible risk of oncologic failure. The aim of this review ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2012.09.010
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Level 1 evidence has demonstrated increased overall survival with cisplatin-based neoadjuvant chemotherapy for patients with muscle-invasive urothelial cancer. Usage remains low, however, in part because neoadjuvant chemotherapy will not be effective for every patient. To identify the patients most likely to...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2016.03.006
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The objective of this study was to investigate positive surgical margin (PSM) rates in patients with prostate cancer treated with radical prostatectomy (RP) and assess PSM impact on cancer-specific mortality (CSM). PATIENTS AND METHODS:Within the Surveillance, Epidemiology, and End Results (SEER) database (...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.09.024
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Venous thromboembolic events (VTEs) frequently occur in cancer patients. Risk assessment models (RAMs) for cancer-associated thrombosis have been proposed. However, advanced urinary tract cancer (aUTC) was not adequately represented in these models. We studied the incidence of VTEs, the risk factors, and the...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.12.021
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION/BACKGROUND:Currently, 7 agents are approved for the first- and second-line therapy for metastatic renal cell carcinoma. In contrast, data supporting their use beyond second line are limited. Here we summarize our experience in patients treated with more than 4 lines of therapy. METHODS:We retrospectively ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.12.012
更新日期:2015-06-01 00:00:00
abstract:INTRODUCTION:Tumor stage and grade represent the best established predictors for the prognosis of upper tract urothelial carcinoma (UTUC). However, controversies still exist regarding the role of tumor necrosis, location, and multifocality in the prognosis of UTUC. We share our experience with 305 patients, reporting o...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.04.017
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Results from large randomized controlled trials combining docetaxel, abiraterone, celecoxib, or bisphosphonates with androgen deprivation therapy (ADT) in hormone-sensitive prostate cancer have emerged. However, in our knowledge, few data are available in patients older than 70 years. Therefore, we undertook...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clgc.2019.05.001
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Scatter factor, also known as hepatocyte growth factor (SF/HGF), is a polypeptide growth factor thought to be important in the growth and spread of prostatic carcinoma. PATIENTS AND METHODS:Scatter factor/HGF levels in pretreatment plasma samples from 171 men with metastatic hormone-refractory prostate canc...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2006.n.006
更新日期:2006-03-01 00:00:00
abstract::Patients receiving androgen deprivation therapy are associated with increasing loss of bone mineral density (BMD) and higher risk of skeletal-related events. We reviewed and analyzed the influence of diphosphonates on BMD change. A systemic literature research was conducted in PubMed and related bibliographies. The fo...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.clgc.2018.07.016
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Non-muscle-invasive bladder cancer (NMIBC) can be treated using transurethral resection (TUR), but high incidence of intravesical recurrence remains a clinical challenge. Single immediate postoperative instillation of chemotherapy (IPIOC) is controversial for NMIBC patients with intermediate recurrence risk....
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.05.028
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Tamoxifen (TAM) has been shown to be active against the bicalutamide-induced breast events (BEs) gynecomastia, and breast pain in patients with prostate cancer (PC). Optimal doses and schedules are not yet established. Debate still exists about whether prophylaxis with TAM is more effective than treatment of...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clgc.2012.03.002
更新日期:2012-09-01 00:00:00
abstract::The spontaneous intraperitoneal rupture of the urinary bladder is an extremely rare and life-threatening event. Often, there are difficulties in establishing the diagnosis. A patient with spontaneous perforation of the urinary bladder, 17 years after successful treatment of an adenocarcinoma of the prostate by pelvic ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.006
更新日期:2007-03-01 00:00:00
abstract::Systemic treatment of men with metastatic prostate cancer is rapidly evolving. Androgen deprivation therapy remains the first-line treatment for advanced disease and the backbone of sequential strategies. For patients with extensive metastatic disease the addition of docetaxel markedly improves survival. In case patie...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2015.01.008
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To prospectively assess the ideal dosing and the value of fluorescent sentinel lymph node (LN) detection with indocyanine green (ICG) for the detection of LN metastases in intermediate- and high-risk patients undergoing robot-assisted prostatectomy and extended pelvic LN dissection (ePLND). PATIENTS AND METH...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.10.014
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Our purpose was to: (1) assess the level of consistency between the quality-of-life (QOL) scores of men with prostate cancer for urinary/bowel/sexual bother, collected via telephone versus self-administered survey; (2) determine factors associated with variation in level of agreement; and (3) assess the ef...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.016
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:To evaluate stage at presentation and cancer-specific mortality (CSM) in upper urinary tract tumors according to histologic subtype. METHODS:Within the Surveillance, Epidemiology, and End Results registry (SEER, 2004-2016), we identified patients with upper urinary tract tumors with pure variant histology (UTV...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.11.004
更新日期:2020-12-02 00:00:00
abstract:BACKGROUND:The programmed death-1 (PD-1) pathway negatively regulates T-cell activation and has an important role in regulating antitumor host immunity. Monoclonal antibodies directed against PD-1 or the PD-1 ligand (PD-L1) have shown activity in several tumor types with preliminary data suggesting a relationship betwe...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.002
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Preliminary studies suggested that selected drug-related toxicities of sunitinib may correlate with a better prognosis. PATIENTS AND METHODS:From January 2006 through December 2015, we retrospectively analyzed data of 145 patients with metastatic renal cell carcinoma treated with sunitinib as a first-line t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.10.003
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:A rapid progression pattern called hyperprogressive disease (HPD) has been observed during early cycles of programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor therapy. Data regarding HPD in patients with genitourinary cancer are limited. PATIENTS AND METHODS:We included 203 pa...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.09.009
更新日期:2020-04-01 00:00:00