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Background: Pharmacoeconomic assessments are a part of the decision process not only during reimbursement setting, but in clinical practice as well. The presented cost-effectiveness analysis assesses panitumumab + mFOLFOX6 vs. bevacizumab + mFOLFOX6 in 1st line treatment of patients with wild-type RAS metastatic colorectal cancer (mCRC) in the Czech environment. Material and Methods: The adaptation of a Markov model considers the health-care perspective; clinical data (efficacy, health-care utilization and adverse events) are derived from a head-to-head comparison (PEAK study). Health states included in the model: progression free on treatment, progression (with/without active treatment), resection of metastases, disease-free after successful resection and death. Actual reimbursement levels were used to estimate costs, published literature to estimate duration of 2nd line treatment. The analysis assumes a life-time horizon; uncertainty was limited by performing one-way and probabilistic sensitivity analyses. Analysis outcomes are life-years gained (LYG) and quality-adjusted life-years (QALYs). Results: Panitumumab + mFOLFOX6 is more effective and more costly in 1st line patients with wild-type RAS mCRC. Incremental costs per QALY are 837,270 CZK, per LYG 615,022 CZK; however, below the willingness-to-pay threshold applied in the Czech Republic. Conclusions: Panitumumab + mFOLFOX6 is cost-effective in 1st line treatment of patients with wild-type RAS mCRC compared to bevacizumab + mFOLFOX6 in the Czech setting. Source

Fiala O.,Onkologicka a radioterapeuticka klinika | Satankova M.,Klinika nemoci plicnich | Kultan J.,Klinika plicnich nemoci | Pesek M.,Klinika pneumologie | And 5 more authors.
Onkologie (Czech Republic) | Year: 2014

Introduction: Low-molecular-weight tyrosine kinase inhibitors for epidermal growth factor receptor (EGFR) are modern, effective agents used to treat patients with advanced non-small-cell lung carcinoma (NSCLC). Activating EGFR gene mutations predict a good effect of treatment with EGFR tyrosine kinase inhibitors. The goal of this study was to map the occurrence of EGFR gene mutations in patients with NSCLC in the Czech Republic. Methods: A total of 486 patients with advanced stage of NSCLC (stage IIIB and IV) of nonsquamous histological type were investigated for the presence of EGFR gene mutations at three pneumo-oncology centres. A comparison of distribution of the EGFR mutation according to sex, age, and smoking status was performed by means of Fisher's exact test. Results: EGFR gene mutation was demonstrated in 74 (15.2%) patients. Mutations were shown in 25 (8.8%) men vs. 49 (24.3%) women (p < 0.001), in 12 (6.7%) smokers vs. 20 (11.2%) ex-smokers vs. 38 (37.3%) non-smokers (p < 0.001), and in 32 (15.7%) patients under 65 years of age vs. 42 (14.9%) patients over 65 years of age (p = 0.898). Conclusion: EGFR gene mutations were shown in 15.2% of the patients examined, most commonly in female patients and non-smokers. The results obtained are well comparable with the data published to date. Source

Fiala O.,Onkologicka a radioterapeuticka klinika | Pesek M.,Klinika Pneumologie a Ftizeologie | Terl M.,Klinika Pneumologie a Ftizeologie | Finek J.,Onkologicka a radioterapeuticka klinika | And 2 more authors.
Studia Pneumologica et Phthiseologica | Year: 2015

The development of diagnostic and therapeutic procedures in recent years have led to considerably longer survival and improved quality of life of patients with advanced-stage non-small cell lung cancer (NSCLC). Undoubtedly, one of the keys to the success is the gradual introduction of the concept of personalized cancer treatment. The concept is based on individualization of the treatment approach based on various predictive factors that help us estimate the response to a particular treatment modality in advance. The review aims at presenting personalized cancer treatment of patients with advanced-stage NSCLC. Source

Background: The efficacy of anticancer therapy is regularly evaluated using the following indicators - objective response rate, progression free survival and overall survival. The change in the tumor burden extent is assessed by the cumulative change in the size of target tumor lesions using imaging methods where WHO and RECIST criteria are most frequently used. The main problem of these criteria is that they use different definitions of response rate evaluation. Generally, existing results of these evaluations do not confirm a direct correlation between the objective response rate and survival (progression free survival or overall survival). Another problem of these methods is that the results of the assessment do not correlate with the biological activity of tumor growth, since it is a static evaluation of clinical status. /Mm: This review article provides an overview of results related to new possibilities for evaluating the efficacy of anticancer therapy using the concept of depth of response and the concept of early tumor shrinkage in patients with metastatic colorectal cancer. Conclusion: The results of numerous post-hoc and exploratory analyses of clinical studies consistently suggest that early tumor shrinkage and depth of response are important variables in assessing the efficacy of systemic anticancer treatment. Source

Skalova A.,Sikluv ustav patologie | Skalova A.,R.O.S.A. | Skalova A.,Onkologicka a radioterapeuticka klinika | Finek J.,Onkologicka a radioterapeuticka klinika
Onkologie (Czech Republic) | Year: 2015

Core cut biopsies are now widely used for non-operative diagnosis of breast lesions. In contrast to fine needle aspiration cytology, core cut biopsy provides sufficient amount of tissue for reliable diagnosis. Histologic structure, classification of carcinoma, grading and markers of predictive oncology can be assesed. The review article deals with some commonly encountered diagnostic problems. Source

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