@article{3122146,
    title = "Patterns of practice and pharmacoeconomic analysis of the management of patients with metastatic renal cell carcinoma (mRCC) in Greece––the CRISIS study. A retrospective analysis by the Hellenic Genitourinary Cancer Group (HGUCG)",
    author = "Tsironis, G. and Koutsoukos, K. and Athanasakis, K. and Tsiara, A. and Tzannis, K. and Gerolympou, M. and Visvikis, A. and Oikonomopoulos, G. and Kollia, A. and Giannopoulou, E. and Dimitra, M. and Kostouros, E. and Papatsoris, A. and Dellis, A. and Stravodimos, K. and Varkarakis, I. and Samantas, E. and Aravantinos, G. and Kentepozidis, N. and Christodoulou, C. and Bozionelou, V. and Dimopoulos, M.A. and Bamias, A.",
    journal = "Expert Review of Pharmacoeconomics and Outcomes Research",
    year = "2019",
    volume = "19",
    number = "4",
    pages = "491-501",
    publisher = "Taylor and Francis Ltd.",
    issn = "1473-7167, 1744-8379",
    doi = "10.1080/14737167.2019.1546121",
    keywords = "axitinib;  everolimus;  nivolumab;  pazopanib;  sorafenib;  sunitinib;  antineoplastic agent;  pazopanib;  pyrimidine derivative;  sulfonamide;  sunitinib, adult;  adverse outcome;  alopecia;  anemia;  Article;  cancer survival;  cardiotoxicity;  controlled study;  cost benefit analysis;  cost effectiveness analysis;  diarrhea;  drug cost;  drug efficacy;  drug safety;  fatigue;  female;  hair discoloration;  hand disease;  human;  hypertension;  hypothyroidism;  kidney metastasis;  liver toxicity;  major clinical study;  male;  middle aged;  mucosa inflammation;  multicenter study;  nausea and vomiting;  nephrotoxicity;  neurotoxicity;  neutropenia;  outcome assessment;  overall survival;  peripheral edema;  practice guideline;  progression free survival;  retrospective study;  skin manifestation;  skin toxicity;  survival rate;  survival time;  taste disorder;  thrombocytopenia;  thrombosis;  aged;  clinical practice;  clinical trial;  disease free survival;  economics;  follow up;  Greece;  kidney tumor;  metastasis;  molecularly targeted therapy;  pharmacoeconomics;  procedures;  renal cell carcinoma;  statistics and numerical data;  very elderly, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Agents;  Carcinoma, Renal Cell;  Cost-Benefit Analysis;  Disease-Free Survival;  Economics, Pharmaceutical;  Female;  Follow-Up Studies;  Greece;  Humans;  Kidney Neoplasms;  Male;  Middle Aged;  Molecular Targeted Therapy;  Neoplasm Metastasis;  Practice Patterns, Physicians';  Pyrimidines;  Retrospective Studies;  Sulfonamides;  Sunitinib;  Survival Rate",
    abstract = "Background:Metastatic RCC (mRCC) treatment has been revolutionized with 11 approved targeted agents. We report patterns of practice, outcomes and pharmacoeconomic analyses after the introduction of targeted therapy. Patients and methods: CRISIS was a retrospective multicenter study of mRCCpatients who received targeted therapy. Results were related to the start of 1st-line therapy, with a cut off at 1 January 2011 in order to depict the impact of increased availability of effective options. Results: 164 patients, were included. 70.1% and 44.5% received 2nd and 3rd-line therapy, respectively. More patients were treated in 2nd-line after 1 January 2011. After a median follow-up of 55.1 months, median progression-free (PFS) and overall survival (OS) were 10.7 (95% confidence intervals [CI]: 8.3–13.7), 7.3 (95% CI: 5.1–8.6), 5.8 (95% CI: 3.8–7.8) and 34 (95% CI: 28.5–39.8), 22.4 (95% CI: 16–32.1), 18.3 (95% CI: 12.4–26.4) months for first, second and third line, respectively. Efficacy of sunitinib and pazopanib in 1st-line were similar. The mean total cost/patient was 35,012.2 Euros (standard deviation [SD]: 28,971.5). Conclusions: Our study confirms previous real-world data suggesting that continuing advances in the treatment of mRCC produce favorable outcomes in everyday practice. Pharmacoeconomic analyses are important for cost-effective utilization of emerging novel therapies. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group."
}