Assuntos
HIV-1/genética , Lentivirus/genética , Técnicas de Amplificação de Ácido Nucleico , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , RNA Viral/análise , Receptores de Antígenos de Linfócitos T/uso terapêutico , Adolescente , Adulto , Criança , Pré-Escolar , Reações Falso-Positivas , Feminino , Vetores Genéticos/genética , Humanos , Técnicas de Amplificação de Ácido Nucleico/métodos , Reação em Cadeia da Polimerase/métodos , RNA Viral/genética , Receptores de Antígenos de Linfócitos T/genética , Transgenes , Adulto JovemRESUMO
OBJECTIVE: To estimate the economic burden of gastrointestinal stromal tumor (GIST) recurrence in patients who received imatinib adjuvant therapy. METHODS: Data from the MarketScan and PharmMetrics databases between January 2000 and March 2013 were extracted. Patients who had received at least one diagnosis of GIST, had undergone a primary surgery for GIST, and had received at least one prescription for imatinib were included in the analysis. An algorithm was applied to identify those who had a subsequent GIST recurrence. Patients who experienced a recurrence and those who did not have a recurrence were compared for differences in healthcare utilization measures and healthcare costs within 6 months after the recurrence, while adjusting for potential confounding factors. RESULTS: A total of 540 patients with primary resectable GIST who received imatinib adjuvant therapy were identified, including 444 (82.2%) patients who did not experience GIST recurrence and 96 (17.8%) patients who did experience recurrence. Patients who experienced GIST recurrence utilized significantly more healthcare resources in all categories than patients who did not have a recurrence, including the number of hospitalizations, days of hospitalization, emergency room visits, outpatient visits, and other medical services (all p-values <0.01). The total healthcare cost was significantly higher for patients with GIST recurrence, with a difference of $4464 per patient per month (p < 0.01). Both the medical and pharmacy costs were significantly higher with adjusted differences of $3488 and $1423 per patient per month, respectively (both p-values <0.01). CONCLUSIONS: Patients who had GIST recurrence after surgical resection incurred significantly more healthcare resource utilization and greater healthcare costs within 6 months after the recurrence than patients who did not have recurrence. These findings suggest that GIST recurrence is associated with a substantial economic burden.
Assuntos
Antineoplásicos/uso terapêutico , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/economia , Mesilato de Imatinib/uso terapêutico , Adulto , Idoso , Algoritmos , Antineoplásicos/economia , Quimioterapia Adjuvante , Feminino , Tumores do Estroma Gastrointestinal/cirurgia , Serviços de Saúde/economia , Serviços de Saúde/estatística & dados numéricos , Humanos , Mesilato de Imatinib/economia , Masculino , Pessoa de Meia-Idade , Recidiva Local de NeoplasiaRESUMO
INTRODUCTION: Breast cancer (BC) is the most common malignancy in women in the USA. Despite the multi-modality treatments that are currently available, advanced BC has a persistent and unacceptable mortality rate. The need for new therapeutic strategies is extremely high. Experimental approaches with targeted therapies such as antibody drug conjugates provide hope for future treatment possibilities. AREAS COVERED: The development status and the possible role of antibody-mediated cytotoxic therapy are discussed in the setting of advanced BC. An overview of, mechanism of action, preclinical and Phase I/II results of glembatumumab vedotin (CDX-011) are discussed. EXPERT OPINION: The evidence that the glycoprotein NBM (GPNMB) target is a relevant target in BC, along with data showing that CDX-011 is safe and active in patients with advanced BC, provide a strong rationale to continue to explore this drug in patients with GPNMB-expressing breast tumors.