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Trevisan B, Pepe FF, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V, Cazzaniga ME. Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients. Sci Rep 2023; 13:12255. [PMID: 37507480 PMCID: PMC10382472 DOI: 10.1038/s41598-023-39386-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
Nowadays, treatment of metastatic breast cancer (MBC) has been enriched with novel therapeutical strategies. Metronomic chemotherapy (mCHT) is a continuous and frequent administration of chemotherapy at a lower dose and so whit less toxicity. Thus, this strategy could be attractive for elderly MBC patients. Aim of this analysis is to provide insights into mCHT's activity in a real-life setting of elderly MBC patients. Data of patients ≥ 75 years old included in VICTOR-6 study were analyzed. VICTOR-6 is a multicentre, Italian, retrospective study, which collected data on mCHT in MBC patients treated between 2011 and 2016. A total of 112 patients were included. At the beginning of mCHT, median age was 81 years (75-98) and in 33% of the patients mCHT was the first line choice. Overall Response Rate (ORR) and Disease Control Rate (DCR) were 27.9% and 79.3%, respectively. Median PFS ranged between 7.6 and 9.1 months, OS between 14.1 and 18.5 months. The most relevant toxicity was the hematological one (24.1%); severe toxicity (grade 3-4) ranged from 0.9% for skin toxicity up to 8% for hematologic one. This is a large study about mCHT in elderly MBC patients, providing insights to be further investigated in this subgroup of frail patients.
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Affiliation(s)
- B Trevisan
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - F F Pepe
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - I Vallini
- Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - E Montagna
- European Institute of Oncology, Milan, Italy
| | | | - R Berardi
- Azienda Ospedaliera Universitaria Ospedali Riuniti, Torrette, Italy
| | - A Butera
- Nuovo Ospedale San Giovanni Di Dio, Florence, Italy
| | | | - L Cavanna
- Azienda Ospedaliera Piacenza, Piacenza, Italy
| | | | - S Cinieri
- Ospedale A. Perrino, Brindisi, Italy
| | | | | | - A Febbraro
- Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Ospedale San Vincenzo, Taormina, Italy
| | - A Ferzi
- Azienda Ospedaliera Ospedale Civile Di Legnano, Magenta, Italy
| | | | - A Fontana
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - O Garrone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V Gebbia
- Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Istituti Ospitalieri Cremona, Cremona, Italy
| | | | | | | | | | - S Sarti
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | - C Putzu
- Azienda Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Ospedale Antonio Cardarelli, Naples, Italy
| | - D Santini
- Università Campus Bio-Medico, RomE, Italy
| | | | | | | | - P Spadaro
- Casa di Cura Villa Salus-Messina, Messina, Italy
| | | | | | | | | | | | - M R Valerio
- A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- INT Regina Elena, Rome, Italy
| | - L Clivio
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
| | - V Torri
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
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Cazzaniga ME, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Di Mauro P, Cogliati V, Capici S, Clivio L, Torri V. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study. Breast Cancer Res Treat 2021; 190:415-424. [PMID: 34546500 PMCID: PMC8558172 DOI: 10.1007/s10549-021-06375-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Purpose Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation.
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Affiliation(s)
- M E Cazzaniga
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy.
- Oncology Unit, ASST Monza, Monza, MB, Italy.
| | - I Vallini
- Medical Oncology, ASST Sette Laghi Ospedale Di Circolo E Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Versilia, ATNO, Lido Di Camaiore, LU, Italy
| | - R Berardi
- Medical Oncology, Università Politecnica Delle Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni Di Dio, Agrigento, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, Bolzano, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese Legnano, Legnano, Italy
| | - A Baldelli
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology 2, Az. Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - O Garrone
- Breast Unit Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - F Giovanardi
- AUSL IRCCS Reggio Emilia Provincial Oncology Unit, Reggio Emilia, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, Italy
| | - S Sarti
- IRCCS Istituto Romagnolo per lo studio dei Tumori (IRST) "Dino Amadori", 47014, Meldola, Italy
| | - A Musolino
- Department of Medicine and Surgery, Medical Oncology and Breast Unit, University of Parma and University Hospital of Parma, Parma, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, Italy
| | - D Santini
- Medical Oncology, Università Campus Bio-Medico, Roma, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria degli Angeli, Pordenone, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus-Messina, Messina, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città della Salute e della Scienza, Osp. Molinette, Torino, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense, Ospedale di Circolo Rho, Rho, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, Italy
| | - M R Valerio
- Department of Discipline Chirurgiche, Oncologiche e Stomatologiche (DICHIRONS), Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- Phase IV trials, IRCCS, INT Regina Elena, Rome, Italy
| | - P Di Mauro
- Oncology Unit, ASST Monza, Monza, MB, Italy
| | - V Cogliati
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - S Capici
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - L Clivio
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
| | - V Torri
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
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Testoni S, Federici I, Guarrera A, Monti M, Stabile S, Taverniti C, Cagnazzo C. 1618P When research becomes “social”: Not only fake news. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cazzaniga ME, Pinotti G, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Fiorentini G, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Melegari E, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study. Breast 2019; 48:7-16. [PMID: 31470257 DOI: 10.1016/j.breast.2019.07.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022] Open
Abstract
Metronomic chemotherapy (mCHT) refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous dosing regimen, with no prolonged drug-free breaks, that leads to antitumor activity. Aim of the present study is to describe the use of mCHT in a retrospective cohort of metastatic breast cancer (MBC) patients in order to collect data regarding the different types and regimens of drugs employed, their efficacy and safety. Between January 2011 and December 2016, data of 584 metastatic breast cancer patients treated with mCHT were collected. The use of VRL-based regimens increased during the time of observation (2011: 16.8% - 2016: 29.8%), as well as CTX-based ones (2011: 17.1% - 2016: 25.6%), whereas CAPE-based and MTX-based regimens remained stable. In the 1st-line setting, the highest ORR and DCR were observed for VRL-based regimens (single agent: 44% and 88%; combination: 36.7% and 82.4%, respectively). Assuming VRL-single agent as the referee treatment (median PFS: 7.2 months, 95% CI: 5.3-10.3), the longest median PFS were observed in VRL-combination regimens (9.5, 95%CI 88.8-11.3, HR = 0.72) and in CAPE-single agent (10.7, 95%CI 8.3-15.8, HR = 0.70). The VICTOR-6 study provides new data coming from the real-life setting, by adding new information regarding the use of mCHT as an option of treatment for MBC patients.
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Affiliation(s)
- M E Cazzaniga
- Research Unit Phase I Trials, ASST Monza, Monza, Italy; Oncology Unit, ASST Monza, Italy.
| | - G Pinotti
- Medical Oncology, ASST Sette Laghi "Ospedale di Circolo e Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Della Versilia, Lido di Camaiore, IT, Italy
| | - R Berardi
- Medical Oncology, A. Ospedaliero-universitaria Ospedali Riuniti, Ancona, IT, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni di Dio, Agrigento, IT, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, IT, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, IT, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, IT, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, IT, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, IT, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese, Legnano, IT, Italy
| | - G Fiorentini
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology, Az. Ospedaliero-Universitaria, Pisana, IT, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli, Sacco, IT, Italy
| | - O Garrone
- Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, IT, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, IT, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, IT, Italy
| | - F Giovanardi
- Medical Oncology, Ospedale Civile, Guastalla, IT, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, IT, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, IT, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, IT, Italy
| | - E Melegari
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - A Musolino
- Medical Oncology, Azienda Ospedaliero-Universitaria di Parma, IT, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, IT, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, IT, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, IT, Italy
| | - D Santini
- Medical Oncology Università Campus Bio-Medico, Roma, IT, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria Degli Angeli, Pordenone, IT, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, IT, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, IT, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus, Messina, IT, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città Della Salute e Della Scienza, Osp. Molinette, Torino, IT, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense 3 Ospedale di Circolo Rho, IT, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, IT, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, IT, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, IT, Italy
| | - M R Valerio
- Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, IT, Italy
| | - P Vici
- Medical Oncology, B, INT Regina Elena, Roma, IT, Italy
| | - L Clivio
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
| | - V Torri
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
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Conte P, Guarneri V, Bisagni G, Piacentini F, Brandes A, Cavanna L, Giotta F, Aieta M, Gebbia V, Frassoldati A, Musolino A, Garrone O, Taverniti C, Rimanti A, Sarti S, Rubino D, Bologna A, Vicini R, Balduzzi S, D'Amico R. 9 weeks versus 1 year adjuvant trastuzumab for HER2+ early breast cancer: Subgroup analysis of the ShortHER trial allows to identify patients for whom a shorter trastuzumab administration may have a favourable risk/benefit ratio. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cagnazzo C, Arizio F, Piccinni Leopardi M, Di Costanzo A, Crotto L, Matocci R, Lucarelli A, Grassi E, Saracino V, Fugazza C, Cinefra M, Marchetti F, Taverniti C, Stabile S, Monti M, Marchesi E. Clinical trials and risk-based approach: reality or Utopia? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Monti M, Campora S, Pirondi S, Gentili G, Guarrera A, Taverniti C, Cagnazzo C. New rules for clinical trials: who will play the game? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cagnazzo C, Campora S, Pirondi S, Guarrera A, Nuzzo A, Gentili G, Taverniti C, Manuela M, Filippi R. Burnout syndrome: What impact on clinical research? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx384.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cagnazzo C, Campora S, Pirondi S, Gentili G, Guarrera A, Taverniti C, Manuela M. Academic clinical research: Enough players to get out there? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx385.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Taverniti C, Bonfadini C, Pradotto M, Cagnazzo C, Demartini P, Rossi L, Ignazzi G, Arizio F, Beano A. Abstract P3-12-06: Saving in clinical trials: A possible challenge for improving health care for breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-12-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The economic crisis that has characterized recent years has required a careful spending review worldwide and particularly in Italy Health Care System. This resulted in substantial cuts in terms of services and drugs prescriptions.
For this reason, it becomes very important to adopt measures aimed to save health care costs, maintaining at the same time the highest standard of health care. The enrollment in clinical trials (CTs) may encourage this goal, making high-cost drugs available.
Methods: We compared the overall expenses for an oncology patient treated with standard therapy (reference: public hospital price list) to a similar patient enrolled in a CT. The cost comparison was made considering a patient affected by Her2 positive breast cancer in three different settings: neoadjuvant, adjuvant, and advanced/metastatic disease. We considered three categories of cost: diagnostic procedures; drug purchase; drug management. All analyses were performed considering an average treatment period and dose, calculated on a middleweight patient.
We take into account the absolute saving in Euro (€) and the percentage one.
Results: The data show a saving in all treatment lines, referring to the analyzed cost groups.
In neoadjuvant setting, the estimated patient standard cost is 92.829,00€; we calculated a saving of 92.451,00€ (93,74%), of which 1.226,00€ for diagnostic procedures charge (65%), 89.205,00€ for drug purchase (100%) and 2.020,00€ for drug management (116%).
In adjuvant setting, where the estimated standard cost is 25.527,00€, we observed a saving of 23.332,00€ (51%): 22.392,00€ (98% of drug purchase) and 940,00€ (54%) for drug management; no saving for diagnostic procedures.
Regarding the metastatic breast cancer treatment, we calculated a saving of 115.158,00€ (88%) compared to 115.571,00€, that means the estimated standard cost. In this case the saving is allocated as follows: 750,00€ for diagnostic procedures (64.5%), 113.508,00€ for drug purchase (100%) and 900,00€ for drug management (100%).
Conclusions: CTs are useful in order to save money in the overall patient management, allowing them to have access to expensive innovative drugs.
Moreover, we have to consider the additional fees provided by Sponsor for each enrolled patient.
This basic model of cost analysis could be used by Institutional Health Care stakeholders for spending review strategies.
The public institutes with the characteristics of Comprehensive Cancer Center are essential to recruiting the needed study population for Sponsorized CTs, and the cashed and saved money can be reinvested for improving Breast Cancer patients care.Background: The economic crisis that has characterized recent years has required a careful spending review worldwide and particularly in Italy Health Care System. This resulted in substantial cuts in terms of services and drugs prescriptions.
For this reason, it becomes very important to adopt measures aimed to save health care costs, maintaining at the same time the highest standard of health care. The enrollment in clinical trials (CTs) may encourage this goal, making high-cost drugs available.
Methods: We compared the overall expenses for an oncology patient treated with standard therapy (reference: public hospital price list) to a similar patient enrolled in a CT. The cost comparison was made considering a patient affected by Her2 positive breast cancer in three different settings: neoadjuvant, adjuvant, and advanced/metastatic disease. We considered three categories of cost: diagnostic procedures; drug purchase; drug management. All analyses were performed considering an average treatment period and dose, calculated on a middleweight patient.
We take into account the absolute saving in Euro (€) and the percentage one.
Results: The data show a saving in all treatment lines, referring to the analyzed cost groups.
In neoadjuvant setting, the estimated patient standard cost is 92.829,00€; we calculated a saving of 92.451,00€ (93,74%), of which 1.226,00€ for diagnostic procedures charge (65%), 89.205,00€ for drug purchase (100%) and 2.020,00€ for drug management (116%).
In adjuvant setting, where the estimated standard cost is 25.527,00€, we observed a saving of 23.332,00€ (51%): 22.392,00€ (98% of drug purchase) and 940,00€ (54%) for drug management; no saving for diagnostic procedures.
Regarding the metastatic breast cancer treatment, we calculated a saving of 115.158,00€ (88%) compared to 115.571,00€, that means the estimated standard cost. In this case the saving is allocated as follows: 750,00€ for diagnostic procedures (64.5%), 113.508,00€ for drug purchase (100%) and 900,00€ for drug management (100%).
Conclusions: CTs are useful in order to save money in the overall patient management, allowing them to have access to expensive innovative drugs.
Moreover, we have to consider the additional fees provided by Sponsor for each enrolled patient.
This basic model of cost analysis could be used by Institutional Health Care stakeholders for spending review strategies.
The public institutes with the characteristics of Comprehensive Cancer Center are essential to recruiting the needed study population for Sponsorized CTs, and the cashed and saved money can be reinvested for improving Breast Cancer patients care.
Citation Format: Taverniti C, Bonfadini C, Pradotto M, Cagnazzo C, Demartini P, Rossi L, Ignazzi G, Arizio F, Beano A. Saving in clinical trials: A possible challenge for improving health care for breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-12-06.
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Affiliation(s)
- C Taverniti
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - C Bonfadini
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - M Pradotto
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - C Cagnazzo
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - P Demartini
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - L Rossi
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - G Ignazzi
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - F Arizio
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
| | - A Beano
- A.O.U. Città della Salute e della Scienza - Breast Unit, Torino, Turin, Italy; University of Turin - San Luigi Hospital, Orbassano, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia - IRCCS, Candiolo, Turin, Italy; AOU Città della Salute e della Scienza - CTO, Turin, Italy
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Marchesi E, Monti M, Campora S, Gentili G, Frati P, Pirondi S, Taverniti C, Cagnazzo C. AIFA Determination 809/2015 on Phase I Clinical Trials: a new challenge for Italian Research. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Taverniti C, Pradotto M, Rossi L, Ignazzi G, Cibrario Rocchietti E, Battista D, Polizzano D, Linardi A, Gianetta M, Alemanni A, Demartini P, Arizio F, Nuzzo A, Cagnazzo C, Bonfadini C. Saving in clinical trial: a possible challenge for health care. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Campora S, Arizio F, Ferretti E, Morabito S, Taverniti C, Marchetti F, Dall'Agata M, Frati P, McMahon L, Ragazzini A, Cagnazzo C. New european clinical trials regulation: perception and expectations in Italy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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