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Fleeman N, Houten R, Nevitt S, Mahon J, Beale S, Boland A, Greenhalgh J, Edwards K, Maden M, Bhattacharyya D, Chaplin M, McEntee J, Chow S, Waddell T. Lenvatinib plus pembrolizumab for untreated advanced renal cell carcinoma: a systematic review and cost-effectiveness analysis. Health Technol Assess 2024; 28:1-190. [PMID: 39252678 PMCID: PMC11404358 DOI: 10.3310/trrm4238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
Background Renal cell carcinoma is the most common type of kidney cancer, comprising approximately 85% of all renal malignancies. Patients with advanced renal cell carcinoma are the focus of this National Institute for Health and Care Excellence multiple technology appraisal. A patient's risk of disease progression depends on a number of prognostic risk factors; patients are categorised as having intermediate/poor risk or favourable risk of disease progression. Objectives The objectives of this multiple technology appraisal were to appraise the clinical effectiveness and cost-effectiveness of lenvatinib plus pembrolizumab versus relevant comparators listed in the final scope issued by the National Institute for Health and Care Excellence: sunitinib, pazopanib, tivozanib, cabozantinib and nivolumab plus ipilimumab. Methods The assessment group carried out clinical and economic systematic reviews and assessed the clinical and cost-effectiveness evidence submitted by Eisai, Hatfield, Hertfordshire, UK (the manufacturer of lenvatinib) and Merck Sharp & Dohme, Whitehouse Station, NJ, USA (the manufacturer of pembrolizumab). The assessment group carried out fixed-effects network meta-analyses using a Bayesian framework to generate evidence for clinical effectiveness. As convergence issues occurred due to sparse data, random-effects network meta-analysis results were unusable. The assessment group did not develop a de novo economic model, but instead modified the partitioned survival model provided by Merck Sharp & Dohme. Results The assessment group clinical systematic review identified one relevant randomised controlled trial (CLEAR trial). The CLEAR trial is a good-quality, phase III, multicentre, open-label trial that provided evidence for the efficacy and safety of lenvatinib plus pembrolizumab compared with sunitinib. The assessment group progression-free survival network meta-analysis results for all three risk groups should not be used to infer any statistically significant difference (or lack of statistically significant difference) for any of the treatment comparisons owing to within-trial proportional hazards violations or uncertainty regarding the validity of the proportional hazards assumption. The assessment group overall survival network meta-analysis results for the intermediate-/poor-risk subgroup suggested that there was a numerical, but not statistically significant, improvement in the overall survival for patients treated with lenvatinib plus pembrolizumab compared with patients treated with cabozantinib or nivolumab plus ipilimumab. Because of within-trial proportional hazards violations or uncertainty regarding the validity of the proportional hazards assumption, the assessment group overall survival network meta-analysis results for the favourable-risk subgroup and the all-risk population should not be used to infer any statistically significant difference (or lack of statistically significant difference) for any of the treatment comparisons. Only one cost-effectiveness study was included in the assessment group review of cost-effectiveness evidence. The study was limited to the all-risk population, undertaken from the perspective of the US healthcare system and included comparators that are not recommended by the National Institute for Health and Care Excellence for patients with untreated advanced renal cell carcinoma. Therefore, the extent to which resource use and results are generalisable to the NHS is unclear. The assessment group cost-effectiveness results from the modified partitioned survival model focused on the intermediate-/poor-risk and favourable-risk subgroups. The assessment group cost-effectiveness results, generated using list prices for all drugs, showed that, for all comparisons in the favourable-risk subgroup, treatment with lenvatinib plus pembrolizumab costs more and generated fewer benefits than all other treatments available to NHS patients. For the intermediate-/poor-risk subgroup, treatment with lenvatinib plus pembrolizumab costs more and generated more benefits than treatment with cabozantinib and nivolumab plus ipilimumab. Conclusions Good-quality clinical effectiveness evidence for the comparison of lenvatinib plus pembrolizumab with sunitinib is available from the CLEAR trial. For most of the assessment group Bayesian hazard ratio network meta-analysis comparisons, it is difficult to reach conclusions due to within-trial proportional hazards violations or uncertainty regarding the validity of the proportional hazards assumption. However, the data (clinical effectiveness and cost-effectiveness) used to populate the economic model are relevant to NHS clinical practice and can be used to inform National Institute for Health and Care Excellence decision-making. The assessment group cost-effectiveness results, generated using list prices for all drugs, show that lenvatinib plus pembrolizumab is less cost-effective than all other treatment options. Study registration This study is registered as PROSPERO CRD4202128587. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis Programme (NIHR award ref: NIHR134985) and is published in full in Health Technology Assessment; Vol. 28, No. 49. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Nigel Fleeman
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Rachel Houten
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Sarah Nevitt
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - James Mahon
- Coldingham Analytical Services, Berwickshire, UK
| | | | - Angela Boland
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Janette Greenhalgh
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Katherine Edwards
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | | | - Marty Chaplin
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | | | - Shien Chow
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Tom Waddell
- The Christie NHS Foundation Trust, Manchester, UK
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Çakar E, Oniangue-Ndza C, Schneider RP, Klijn SL, Vogl UM, Rothermundt C, May JR. Cost-Effectiveness of Nivolumab Plus Ipilimumab for the First-Line Treatment of Intermediate/Poor-Risk Advanced and/or Metastatic Renal Cell Carcinoma in Switzerland. PHARMACOECONOMICS - OPEN 2023:10.1007/s41669-023-00395-1. [PMID: 36757568 DOI: 10.1007/s41669-023-00395-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study assessed the cost-effectiveness of nivolumab plus ipilimumab versus both sunitinib and pazopanib for the treatment of first-line unresectable advanced renal cell carcinoma (aRCC) from a healthcare system perspective in Switzerland. METHODS A three-state partitioned survival model, consisting of progression-free, progressed disease, and death, was constructed. Efficacy estimates were based on data from the CheckMate 214 trial (NCT02231749) with a minimum follow-up of 42 months. Two Swiss oncologists were consulted to determine disease management resource use. Costs were derived from the Swiss tariff lists for outpatient (TARMED Online Browser 1.09) and inpatient (2020 data from Swiss diagnosis-related groups) treatments. Drug acquisition costs (ex-factory prices) were obtained from the March 2020 price list published by the Swiss Federal Office of Public Health. Treatment-specific EQ-5D-3L-based utilities were derived from CheckMate 214 using a French value set as a proxy for Switzerland. The model utilized a 1-week cycle length and a 40-year time horizon, with costs and effects discounted by 3.0% per annum. One-way sensitivity analyses, probabilistic analysis, and scenario analyses assessed the robustness of the results. RESULTS Nivolumab plus ipilimumab yielded incremental 1.43 life-years and 1.36 lifetime discounted quality-adjusted life-years (QALYs) relative to sunitinib and pazopanib at an additional cost of 147,453 Swiss Francs (CHF) and CHF145,643, respectively. With an incremental cost-utility ratio of CHF108,326 per QALY gained versus sunitinib, and CHF106,996 per QALY gained versus pazopanib, the nivolumab plus ipilimumab combination can be considered a cost-effective option for the treatment of patients with aRCC in Switzerland, with a willingness-to-pay threshold of CHF200,000. Sensitivity and scenario analyses confirmed the robustness of the deterministic results. CONCLUSIONS This study showed that nivolumab plus ipilimumab, which represents one of the standard-of-care first-line treatments for intermediate- or poor-risk aRCC patients, is a life-extending and cost-effective treatment option for patients in Switzerland.
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Affiliation(s)
| | - César Oniangue-Ndza
- Bristol Myers Squibb SA, Hinterbergstrasse 16, 6330, Steinhausen, Switzerland.
| | - Ralph P Schneider
- Bristol Myers Squibb SA, Hinterbergstrasse 16, 6330, Steinhausen, Switzerland
| | | | - Ursula M Vogl
- Istituto Oncologico della Svizzera Italiana (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Christian Rothermundt
- Klinik für Medizinische Onkologie und Hämatologie, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Naito S, Kato T, Numakura K, Hatakeyama S, Koguchi T, Kandori S, Kawasaki Y, Adachi H, Kato R, Narita S, Yamamoto H, Ogawa S, Kawamura S, Obara W, Ito A, Nishiyama H, Kojima Y, Ohyama C, Habuchi T, Tsuchiya N. Prognosis of Japanese metastatic renal cell carcinoma patients in the targeted therapy era. Int J Clin Oncol 2021; 26:1947-1954. [PMID: 34191191 DOI: 10.1007/s10147-021-01979-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/25/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND The aims of this study were to investigate prognosis and validate prognostic models [Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic Renal Cell Carcinoma Data Consortium (IMDC), and Japanese metastatic renal cancer (JMRC) models] in the targeted therapy era in Japanese patients with metastatic renal cell carcinoma. METHODS We retrospectively analyzed 692 patients who were diagnosed with mRCC from January 2008 to August 2018 in the Michinoku Japan Urological Cancer Study Group database. Nivolumab as sequential therapy was widely used. Other immune checkpoint inhibitors were excluded from this study. RESULTS The median overall survival (95% confident interval) in all, MSKCC favorable, intermediate, and poor risk patients was 41.0 months (33.9-46.8), not reached (63.5 to not estimable), 46.8 months (37.1-52.9), and 10.4 months (8.9-14.4), respectively. The median overall survival (95% confident interval) in IMDC favorable, intermediate, and poor risk patients was not reached (61.6 to not estimable), 47.4 months (41.4-56.5), and 11.5 (9.9-16.3), respectively. The c-index of the MSKCC, IMDC, and JMRC models calculated at mRCC diagnosis was 0.680, 0.689, and 0.700, respectively. No statistical differences were found in the c-index among the models. CONCLUSION While the real-world overall survival in Japanese patients with mRCC in the targeted therapy era improved compared to that previously reported in the cytokine era, there was no clear difference in the survival of poor risk patients between these eras. There were no differences in the superiority among the models.
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Affiliation(s)
- Sei Naito
- Department of Urology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan.
| | - Tomoyuki Kato
- Department of Urology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan
| | - Kazuyuki Numakura
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita, 010-8543, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan
| | - Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine, 1 hikarigaoka, Fukushima, 960-1295, Japan
| | - Shuya Kandori
- Department of Urology, University of Tsukuba Graduate School of Medicine, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Yoshihide Kawasaki
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hisanobu Adachi
- Department of Urology, Miyagi Cancer Center, 47-1, Nodayama, Shiote, Medeshima, Natori, Miyagi, 981-1293, Japan
| | - Renpei Kato
- Department of Urology, Iwate Medical University School of Medicine, Yahaba 2-1-1, Shiwa, Iwate, 028-3695, Japan
| | - Shintaro Narita
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita, 010-8543, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan
| | - Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine, 1 hikarigaoka, Fukushima, 960-1295, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, 47-1, Nodayama, Shiote, Medeshima, Natori, Miyagi, 981-1293, Japan
| | - Wataru Obara
- Department of Urology, Iwate Medical University School of Medicine, Yahaba 2-1-1, Shiwa, Iwate, 028-3695, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, University of Tsukuba Graduate School of Medicine, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, 1 hikarigaoka, Fukushima, 960-1295, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita, 010-8543, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan
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Bazarbashi S, Alsharm A, Azam F, El Ashry H, Zekri J. The clinical significance of routine risk categorization in metastatic renal cell carcinoma and its impact on treatment decision-making: a systematic review. Future Oncol 2020; 16:2879-2896. [PMID: 32869660 DOI: 10.2217/fon-2020-0500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: To analyze responses to first-line metastatic renal cell carcinoma (mRCC) treatment stratified by risk criteria. Patients & methods: Clinical trials and observational studies of patients aged ≥18 years, published January 2005-May 2019, were identified via Ovid from MEDLINE, EMBASE, the Cochrane Central Trials Register and the Cochrane Database of Systematic Reviews. Data extracted included progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). Results: 47/1269 articles met eligibility criteria. Most studies stratified patients by International Metastatic RCC Database Consortium (n = 19) or Memorial Sloan Kettering Cancer Center (n = 21). PFS, OS and ORR varied according to risk group. Conclusion: Pembrolizumab + axitinib, ipilimumab + nivolumab and avelumab + axitinib were most effective across all risk groups. Favorable-risk patients benefit from sunitinib treatment.
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Affiliation(s)
- Shouki Bazarbashi
- Department of Medical Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Faculty of Medicine, Alfaisal University, Riyadh, 12713, Saudi Arabia
| | - Abdullah Alsharm
- Department of Medical Oncology, King Fahad Medical City, Riyadh, 12231, Saudi Arabia
| | - Faisal Azam
- Department of Medical Oncology, King Fahad Specialist Hospital, Dammam, 32253, Saudi Arabia
| | - Hazem El Ashry
- Department of Medical Affairs, Pfizer Ltd, Jeddah, 21391, Saudi Arabia
| | - Jamal Zekri
- Department of Medical Oncology, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
- College of Medicine, Al-Faisal University, Riyadh, 11533, Saudi Arabia
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Outcomes According to MSKCC Risk Score with Focus on the Intermediate-Risk Group in Metastatic Renal Cell Carcinoma Patients Treated with First-Line Sunitinib: A Retrospective Analysis of 2390 Patients. Cancers (Basel) 2020; 12:cancers12040808. [PMID: 32230921 PMCID: PMC7225945 DOI: 10.3390/cancers12040808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 01/01/2023] Open
Abstract
Background: The Memorial Sloan–Kettering Cancer Center (MSKCC) prognostic model has been widely used for the prediction of the outcome of metastatic renal cell carcinoma (mRCC) patients treated with systemic therapies, however, data from large studies are limited. This study aimed at the evaluation of the impact of the MSKCC score on the outcomes in mRCC patients treated with first-line sunitinib, with a focus on the intermediate-risk group. Methods: Clinical data from 2390 mRCC patients were analysed retrospectively. Progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were analysed according to the MSKCC risk score. Results: ORR, median PFS, and OS for patients with one risk factor were 26.7%, 10.1, and 28.2 months versus 18.7%, 6.2, and 16.2 months, respectively, for those with two risk factors (ORR: p = 0.001, PFS: p < 0.001, OS: p < 0.001). ORR, median PFS, and OS were 33.0%, 17.0, and 44.7 months versus 24.1%, 9.0, and 24.1 months versus 13.4%, 4.5, and 9.5 months in the favourable-, intermediate-, and poor-risk groups, respectively (ORR: p < 0.001, PFS: p < 0.001, OS: p < 0.001). Conclusions: The results of the present retrospective study demonstrate the suitability of the MSKCC model in mRCC patients treated with first-line sunitinib and suggest different outcomes between patients with one or two risk factors.
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Wiechno P, Kucharz J, Sadowska M, Michalski W, Sikora-Kupis B, Jonska-Gmyrek J, Poniatowska G, Nietupski K, Ossolinski K, Demkow T. Contemporary treatment of metastatic renal cell carcinoma. Med Oncol 2018; 35:156. [PMID: 30368624 DOI: 10.1007/s12032-018-1217-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/24/2018] [Indexed: 12/25/2022]
Abstract
Renal cell carcinoma is the 14th most common cancer worldwide. It is a heterogeneous group of histopathological entities, of which the most common is clear cell renal cell carcinoma. Approximately 20-30% of patients present initially with metastatic disease and an additional 20% will progress after radical surgical treatment. Metastatic disease that is non-feasible for surgical treatment remains incurable. Numerous studies have demonstrated that-with the introduction of new drugs-the treatment outcomes of metastatic disease have improved. The development of new therapies as well as the optimization and individualization of procedures allow us to hope for further progress in this area.
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Affiliation(s)
- Pawel Wiechno
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Jakub Kucharz
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland.
| | - Malgorzata Sadowska
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Wojciech Michalski
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Bozena Sikora-Kupis
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Joanna Jonska-Gmyrek
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Grazyna Poniatowska
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Karol Nietupski
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Krzysztof Ossolinski
- Department of Urology, The John Paul II District Hospital in Kolbuszowa, Kolbuszowa, Poland
| | - Tomasz Demkow
- Department of Uro-oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5, Roentgen Street, 02-781, Warsaw, Poland
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Abstract
Context: The rate of progression to metastatic disease in patients undergoing active surveillance for small renal tumors varies in the literature between 1% and 8%. Aims: This study aims to examine the incidence of metastasis in small renal tumors of <4 cm in a Danish cohort. Settings and Design: Retrospective. Materials and Methods: Data on 106 patients who were diagnosed with renal cancer (RCC) of <4 cm by CT scan from January 2005 to December 2013 were collected retrospectively in January 2016 from patient charts and analyzed. Statistical Analysis Used: The cancer-specific survival (CSS) and overall survival (OS) were estimated using Kaplan-Meier methods. Results: The mean age was 62 years (range 40–84 years). Two patients (1.9%) had metastases at the time of diagnosis. Radical nephrectomy was performed in 74 patients (70%); of them, one patients (1.4%) experienced late metastasis (LM). Partial nephrectomy was performed in 30 patients (28%); of them, two patients (6.7%) experienced LM. The mean time to LM was 27 ± 12 months (95% confidence interval: 4–56). CSS rates were 98%, 97%, and 97% for 1, 3, and 5 years, respectively, while OS rates were 96%, 92%, and 86% for 1, 3, and 5 years, respectively. On multivariate analysis, tumor size (P = 0.04), pT3a (P = 0.0017), and patient's age (P = 0.02) at the time of diagnosis were significant predictors of LM. Conclusions: Even small renal carcinomas may be aggressive, and caution should be taken when offering active surveillance.
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Affiliation(s)
- Nessn H Azawi
- Department of Urology, Zealand University Hospital, Roskilde, Denmark.,Clinical Institute of University of Southern Denmark, Odense, Denmark
| | - Lars Lund
- Clinical Institute of University of Southern Denmark, Odense, Denmark.,Department of Urology, Odense University Hospital, Odense, Denmark
| | - Mikkel Fode
- Department of Urology, Zealand University Hospital, Roskilde, Denmark
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Real-World Effectiveness of Everolimus Subsequent to Different First Targeted Therapies for the Treatment of Metastatic Renal Cell Carcinoma: Synthesis of Retrospective Chart Reviews. Clin Genitourin Cancer 2016; 14:160-7.e3. [DOI: 10.1016/j.clgc.2015.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 10/26/2015] [Accepted: 11/08/2015] [Indexed: 12/17/2022]
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Lee S, Nemeño JGE, Lee JI. Repositioning Bevacizumab: A Promising Therapeutic Strategy for Cartilage Regeneration. TISSUE ENGINEERING PART B-REVIEWS 2016; 22:341-357. [PMID: 26905221 DOI: 10.1089/ten.teb.2015.0300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Drug discovery and development has been garnering an increasing trend of research due to the growing incidence of the diverse types of diseases. Recently, drug repositioning, also known as drug repurposing, has been emerging parallel to cancer and tissue engineering studies. Drug repositioning involves the application of currently approved or even abandoned drugs as alternative treatments to other diseases or as biomaterials in other fields including cell therapy and tissue engineering. In this review, the advancement of the antiangiogenesis drugs that were used as treatment for cancer and other diseases, with particular focus on bevacizumab, will be described. This will include an overview of the nature and progression of osteoarthritis (OA), one of the leading global degenerative diseases that cause morbidity, and the development of its therapeutic strategies. In addition, this will also feature the nonsteroidal anti-inflammatory drugs that are commonly prescribed for OA and the benefits of repositioning bevacizumab as alternative treatments for other diseases and as biomaterials for cartilage regeneration. To date, a few number of studies, employing different modes of administration and varying dosages in diverse animal models, have shown that bevacizumab can be used as a signal and can promote both in vitro and in vivo cartilage regeneration. However, other antiangiogenesis drugs and their effects in chondrogenesis and cartilage regeneration are also worth investigating.
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Affiliation(s)
- Soojung Lee
- 1 Regenerative Medicine Laboratory, Department of Biomedical Science and Technology, Center for Stem Cell Research, Institute of Biomedical Science & Technology, Konkuk University , Seoul, Republic of Korea
| | - Judee Grace E Nemeño
- 1 Regenerative Medicine Laboratory, Department of Biomedical Science and Technology, Center for Stem Cell Research, Institute of Biomedical Science & Technology, Konkuk University , Seoul, Republic of Korea
| | - Jeong Ik Lee
- 1 Regenerative Medicine Laboratory, Department of Biomedical Science and Technology, Center for Stem Cell Research, Institute of Biomedical Science & Technology, Konkuk University , Seoul, Republic of Korea.,2 Deparment of Veterinary Medicine, College of Veterinary Medicine, Konkuk University , Seoul, Republic of Korea
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