TY - JOUR
TI - Treating EGFR-Mutated Oncogene-Addicted Advanced Non-Small-Cell Lung
Cancer in the Era of Economic Crisis in Greece: Challenges and
Opportunities
AU - Fountzilas, Elena
AU - Levva, Sofia
AU - Mountzios, Giannis and
AU - Polychronidou, Genovefa
AU - Maniadakis, Nikos
AU - Kotoula, Vassiliki and
AU - Fountzilas, George
JO - JOURNAL OF GLOBAL ONCOLOGY
PY - 2018
VL - 4
TODO - null
SP - null
PB - AMER SOC CLINICAL ONCOLOGY 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA
SN - null
TODO - 10.1200/JGO.18.00115
TODO - null
TODO - Purpose Because of the profound financial crisis that commenced in
Greece in 2010, severe cuts in health care spending and other
restriction measures led to significant delays in the reimbursement of
novel antineoplastic agents. In 2011, the Hellenic Society of Medical
Oncology initiated a program of early access to epidermal growth factor
receptor (EGFR) tyrosine kinase inhibitors for the treatment of patients
with advanced, EGFR-mutant non-small-cell lung cancer (NSCLC). We
evaluated treatment patterns and clinical outcomes in patients with
EGFR-mutant or wild-type disease treated at a large center in Greece
throughout the period of financial crisis.
Patients and Methods From 2011 through 2015, 252 patients with newly
diagnosed advanced NSCLC were treated at the Department of Medical
Oncology of the Papageorgiou Hospital, a tertiary cancer center in
northern Greece. We retrospectively reviewed patient medical records to
obtain clinicopathologic characteristics, EGFR mutation status, and
follow-up data. The primary end point was time to treatment failure.
Results Of the 198 evaluable patients, 25 (12%) had EGFR mutations. All
patients with EGFR mutations except one received treatment with an EGFR
tyrosine kinase inhibitor. Median times to treatment failure for
patients with EGFR-mutant and wild-type disease were 15.8 and 7.1
months, respectively (hazard ratio, 0.58; 95% CI, 0.35 to 0.95; P =
.031). There was no difference in overall survival between the two
groups (P = .293). No deviation from treatment guidelines or
discontinuation of treatment regimens occurred because of logistic
reasons or drug shortages.
Conclusion Despite restrictions in the reimbursement policy and
accompanying controls in the use of high-cost medicines, the national
program enabled treatment of patients with EGFR-mutant NSCLC according
to established guidelines. Therefore, the clinical outcomes of such
patients treated in Greece during the economic crisis were in accordance
with international standards. (C) 2018 by American Society of Clinical
Oncology
ER -