AROME-ESO Oncology Consensus Conference: access to cancer care innovations in countries with limited resources. Association of Radiotherapy and Oncology of the Mediterranean Area (AROME-Paris) and European School of Oncology (ESO - Milan).

PURPOSE: Cancer is a leading cause of mortality worldwide. Its incidence is still increasing, particularly in developing countries. Recent progresses further strengthen the differences between low/middle and high-income countries. This situation calls for joint action to reduce inequities in cancer outcomes among the patients. The Association of Radiotherapy and Oncology of the Mediterranean Area (AROME) and the European School of Oncology (ESO), have initiated joint conferences devoted to access to innovations in oncology in the Mediterranean area. The heterogeneity of the economic, political and cultural situations of the different participating countries, offers the opportunity to develop consensus conference. METHODS: Cancer prevention and treatment strategies were discussed according to existing international guidelines. The Scientific committee prepared 111 questions with an objective to prioritize the access to treatments and innovations in low/middle-income Mediterranean countries. The results from the votes of 65 oncology experts, coming from 16 countries and 33 institutions have been analysed and access priorities classified accordingly. RESULTS: Ninety six percent of the proposed general recommendations concerning national health care strategies, oncology education, and treatment organization were considered to be high priorities. Regarding access to systemic treatments, 41% of the drugs without validated predictive markers and 53% of those with validated predictive markers were considered to be 1st level priority. Only 4 biological tests were considered to be 1st level priority to access to innovation. CONCLUSIONS: AROME-ESO consensus offers to cancer specialists from developing countries a basis for discussion with health authorities and payers on the prioritization of access to innovations in cancer care.

Evaluation of safety of bevacizumab as second-line treatment of patients with metastatic colorectal cancer.

PURPOSE: Bevacizumab is a relatively new monoclonal antibody introduced in the treatment of metastatic colorectal cancer (CRC). Since varied efficiency and adverse events of this drug were reported, the purpose of this study was to assess the safety of bevacizumab as second-line treatment of patients with metastatic CRC. METHODS: This observational, non-interventional study involved 35 patients with metastatic CRC treated with bevacizumab. Patients were from the Oncology Clinic, Clinical Centre of Montenegro. Monitoring of patients was done according to the study protocol. RESULTS: The number of subjects with abnormal values of tumor marker CEA has decreased from 56.8% (enrollment visit) to 50% in the sixth visit (p<0.01). The number of subjects with abnormal values for tumor marker Ca19-9 ranged from initial 45% (enrollment visit) to 50% on the sixth visit (p>0.05). No significant differences in the average values of hematological and biochemical parameters and the average values of the CEA and Ca19-9 were noticed. In 26 (46.2%) patients, adverse events were recorded. Of 72 adverse events, 31 (43.05%) were related to bevacizumab. Regarding adverse events intensity, 68.1% were moderate. The most common adverse event was hypertension, which was recorded in 12 patients. There was no life-threatening adverse event connected with the drug use. CONCLUSION: Use of bevacizumab caused moderate adverse effects, none of which was life-threatening.