Health Care Costs Among Renal Cancer Patients Using Pazopanib and Sunitinib.

Publications that aim to assess the economics of different therapies are important because they complement clinical trial data and may aid in decision making. We therefore read with interest the study by Hansen et al. in the January 2015 issue of JMCP. This study compared  costs between pazopanib (PAZ) and sunitinib (SU) in the first-line treatment of patients with metastatic renal cell carcinoma (mRCC).1 The authors assessed health care costs through assignment of costs from the Truven Health MarketScan Databases to the self-reported health care resource utilization (HCRU) data from the population studied in the phase III noninferiority clinical trial COMPARZ (Pazopanib versus sunitinib in metastatic renal cell carcinoma).2 We are writing to comment on the conclusions drawn from the results presented, the methodology used, and to request additional information and clarification on data presented.

The promise of thalidomide: evolving indications.

Thalidomide was first used in the late 1950s but it was withdrawn from the market in the 1960s for its notorious teratogenic effects. This drug was more recently rediscovered as a powerful immunomodulatory and antiinflammatory agent and was approved by the FDA in 1998 for treatment of erythema nodosum leprosum. Thalidomide has shown great promise in advanced or refractory multiple myeloma either alone or in combination with other agents. It has also demonstrated benefits in a wide variety of disparate conditions such as aphthous and genital ulcers, cancer cachexia, HIV, tuberculosis and chronic graft versus host disease. Thalidomide is being investigated for treatment of renal cell carcinoma, and liver and thyroid cancers. Better understanding of its many mechanisms of action has provoked great interest in its potential use for treatment of various disorders. This review focuses on thalidomide's mechanisms of action, biochemistry, pharmacokinetics and its use in erythema nodosum leprosum as well as multiple myeloma, graft versus host disease, and renal cell carcinoma.