Background The use of innovative anticancer drugs in patients with various advanced tumours allows disease control with improved quality of life. This perspective must identify mechanisms to make additional costs arising from the most recent therapeutic advances affordable.
Purpose To evaluate the correct use and prescription methods of two new drugs in metastatic breast cancer in patients for whom the standard treatment for advanced disease has failed.
Materials and Methods Patients treated from April 2011 to May 2012 with Abraxane and from March 2012 to June 2012 with Halaven were extrapolated (start dates corresponded to the inclusion of drugs in the Hospital Therapeutic Handbook). For each patient individual doses were extrapolated and integrated with clinical data reported in the medical records.
Results 25 patients were treated with Abraxane, 10 with Halaven, while 3 received both treatments. Of the 25 patients treated with Abraxane, 9 (36%) received the drug after at least 10 lines of treatment, 11 (44%) after 6–9 lines, 5 (20%) after 1–5 lines. 16 patients were treated according to SPC: 260 mg/m²/day 1 q 21 (64%), 9 with an off-label schedule: 100 mg/m²/day 1.8 q 21 (36%). Furthermore it was found that a dose reduction not corresponding to what was reported in the SmPC was often used. Among patients treated with Halaven, 8 (80%) had received 8–15 prior lines of treatment, only 2 (20%) began treatment in 3rd–4th line. Among patients who went into progression (17 patients, 68%), only 18% reached 10 doses, 6% achieved 7–9 doses, 23% 4–6 doses and the majority (53%) did not exceed 1–3 doses of the medicine.
Conclusions The evaluation of these data suggests the need for a more accurate selection of patients based on predictive baseline characteristics or early indicators of activities and the implementation of post-registration studies to confirm the efficacy and safety of these drugs.
No conflict of interest.
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