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Article

Use of Targeted Therapy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Economic Impact in a Canadian Real-Life Setting

1
Research Institute of the McGill University Health Centre, 5252 De Maisonneuve Boulevard West, Montreal, QC H4A 3S5, Canada
2
McMaster University, Hamilton, ON L8S 4L8, Canada
3
Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada
4
University of British Columbia, Vancouver, BC V6T 1Z4, Canada
5
Dalhousie University and QEII Health Sciences Centre, Halifax, NS B3H 2Y9, Canada
6
Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada
7
Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
8
Centre hospitalier de l’Université de Montréal, University of Montreal, Montreal, QC H3T 1J4, Canada
9
University of Ottawa, Ottawa, ON K1N 6N5, Canada
10
Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada
11
Centre hospitalier universitaire de Québec, University of Laval, Quebec City, QC G1V 0A6, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(6), 576-584; https://doi.org/10.3747/co.25.4103
Submission received: 8 September 2018 / Revised: 11 October 2018 / Accepted: 3 November 2018 / Published: 1 December 2018

Abstract

Introduction Outside 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. Methods The 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. Results The 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. Conclusions For 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.
Keywords: renal cell carcinoma; targeted therapy; effectiveness; safety; real-world data renal cell carcinoma; targeted therapy; effectiveness; safety; real-world data

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MDPI and ACS Style

Nazha, S.; Tanguay, S.; Kapoor, A.; Jewett, M.; Kollmannsberger, C.; Wood, L.; Bjarnason, G.; Heng, D.; Soulières, D.; Reaume, N.; et al. Use of Targeted Therapy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Economic Impact in a Canadian Real-Life Setting. Curr. Oncol. 2018, 25, 576-584. https://doi.org/10.3747/co.25.4103

AMA Style

Nazha S, Tanguay S, Kapoor A, Jewett M, Kollmannsberger C, Wood L, Bjarnason G, Heng D, Soulières D, Reaume N, et al. Use of Targeted Therapy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Economic Impact in a Canadian Real-Life Setting. Current Oncology. 2018; 25(6):576-584. https://doi.org/10.3747/co.25.4103

Chicago/Turabian Style

Nazha, S., S. Tanguay, A. Kapoor, M. Jewett, C. Kollmannsberger, L. Wood, G. Bjarnason, D. Heng, D. Soulières, N. Reaume, and et al. 2018. "Use of Targeted Therapy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Economic Impact in a Canadian Real-Life Setting" Current Oncology 25, no. 6: 576-584. https://doi.org/10.3747/co.25.4103

APA Style

Nazha, S., Tanguay, S., Kapoor, A., Jewett, M., Kollmannsberger, C., Wood, L., Bjarnason, G., Heng, D., Soulières, D., Reaume, N., Basappa, N., Lévesque, E., & Dragomir, A. (2018). Use of Targeted Therapy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Economic Impact in a Canadian Real-Life Setting. Current Oncology, 25(6), 576-584. https://doi.org/10.3747/co.25.4103

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