Initial Patterns of Care With Oral Targeted Therapies for Patients With Renal Cell Carcinoma - 20/08/11
Résumé |
Objectives |
To characterize the contemporary use of oral-targeted therapies (ie, sunitinib, sorafenib) among patients with renal cell carcinoma (RCC) and to assess the factors associated with short-term and sequential treatment.
Methods |
We used an administrative claims database of privately insured patients to evaluate oral-targeted therapy use among patients with RCC from 2006 to 2007. After identifying patients with RCC who had received sunitinib and/or sorafenib, we determined the prevalence of patients treated with short-term and/or sequential therapy. We performed bivariate and multivariate analyses to estimate the associations between the patient characteristics and receipt of short-term and/or sequential treatment regimens.
Results |
We identified 938 patients with RCC who had initially been treated with sunitinib (n = 554) or sorafenib (n = 384). In this group, 36% and 23% of patients had received short-term or sequential therapy, respectively. Most patients (61%) who had received sequential therapy had undergone short-term treatment with ≥1 drugs, with second-line sorafenib more likely to be given as short-term therapy than sunitinib (63% vs 34%, P < .001). Short-term therapy was more common in female patients (odds ratio 1.53, 95% confidence interval 1.12-2.09) and patients in the Southern United States (odds ratio 1.71, 95% confidence interval 1.05-2.80). Sequential therapy was more common among patients receiving sorafenib first (odds ratio 2.30, 95% confidence interval 1.64-3.21).
Conclusions |
Short-term and sequential oral targeted therapy use was relatively prevalent among patients with RCC. For patients treated with sunitinib and sorafenib, the patterns of short-term use varied by the sequence of medications, suggesting differences in the effectiveness or tolerability of each regimen. These findings highlight the need for future studies to characterize the “real-world” clinical outcomes and economic effect associated with these treatment courses.
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This research was supported by the National Institutes of Health Clinical Training Grant in Urology (NIH-T32-DK007782) to C. P. Filson, and the Edwin Beer Research Fellowship in Urology and Urology-Related Fields from the New York Academy of Medicine and the University of Michigan Cancer Center Munn Idea Grant to D. C. Miller |
Vol 77 - N° 4
P. 825 - avril 2011 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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