Comparative Analysis of the Seriousness of the Adverse Events and Risk of Targeted Therapy for Metastatic Renal Cell Carcinoma Among Medical Professionals

전이성신세포암 표적치료제의 부작용 심각도 및 위해에 대한 전문가그룹별 비교분석

  • Park, Mi-Hae (Graduate School of Clinical Pharmacy, Sookmyung Women's University) ;
  • Rhee, Jin-Nie (Graduate School of Clinical Pharmacy, Sookmyung Women's University) ;
  • Lee, Eui-Kyung (Graduate School of Clinical Pharmacy, Sookmyung Women's University)
  • 박미혜 (숙명여자대학교 임상약학대학원) ;
  • 이진이 (숙명여자대학교 임상약학대학원) ;
  • 이의경 (숙명여자대학교 임상약학대학원)
  • Received : 2011.04.04
  • Accepted : 2011.06.04
  • Published : 2011.06.30

Abstract

The perception of the 20 adverse events of targeted therapy for metastatic renal cell carcinoma was compared among medical professionals. Thirty-seven oncologists, 167 nurses and 79 pharmacists participated in the survey, and the response rate was 61.9%, 98.2%, 84.9%, respectively. Results showed that the most serious adverse event was GI perforation (8.83 points, 10 being the most serious), whereas the least serious was anemia (5.32 points). There were significant differences among oncologists, nurses and pharmacists especially for the moderately-serious adverse event such as wound-healing complication and lymphopenia. Adverse Events Composite Score (AECS) for each targeted therapy was calculated by multiplying adverse event incidence rate and seriousness score. Sunitinib had the highest score at 6.86 point and bevacizumab had the lowest at 2.1. Among professional groups oncologists showed the lowest AECS, whereas nurses had the highest. The gap on the perception of the adverse events among medical professionals needs to be reduced to get better outcomes of medical therapies for cancer patients.

Keywords

References

  1. Motzer RJ, Bander NH, Nanus DM. Renal-cell carcinoma. N Engl J Med 1996; 335: 865-75. https://doi.org/10.1056/NEJM199609193351207
  2. McDermott DF. Update on the application of interleukin-2 in the treatment of renal cell carcinoma. Clin Cancer Res 2007; 13: 716s-20s. https://doi.org/10.1158/1078-0432.CCR-06-1872
  3. Molina AM, Motzer RJ. Clinical Practice Guidelines for the Treatment of Metastatic Renal Cell Carcinoma: Today and Tomorrow. The oncologist 2011; 16:45. https://doi.org/10.1634/theoncologist.2011-S2-45
  4. Hutson TE, Figlin RA, Kuhn JG, Motzer RJ. Targeted therapies for metastatic renal cell carcinoma: an overview of toxicity and dosing strategies. Oncologist 2008; 13: 1084-96. https://doi.org/10.1634/theoncologist.2008-0120
  5. Thompson Coon J, Hoyle M, Green C, et al., Bevacizumab, sorafenib tosylate, sunitinib and temsirolimus for renal cell carcinoma: a systematic review and economic evaluation. Health Technol Assess 2010; 14: 1-184, iii-iv.
  6. World Health Organization (WHO), Benefit-Risk Balance for Marketed Drugs: Evaluating Safety Signals, In: Report of CIOMS Working Group IV; Geneva: 1998.
  7. Escudier B, Pluzanska A, Koralewski P, et al., Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet 2007; 370: 2103-11. https://doi.org/10.1016/S0140-6736(07)61904-7
  8. Hudes G, Carducci M, Tomczak P, et al., Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 2007; 356: 2271-81 https://doi.org/10.1056/NEJMoa066838
  9. Motzer RJ, Hutson TE, Tomczak P, et al., Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. Clin Oncol 2009; 27: 3584-90. https://doi.org/10.1200/JCO.2008.20.1293
  10. Mickisch G, Gore M, Escudier B, Procopio G, Walzer S, Nuijten M. Costs of managing adverse events in the treatment of first-line metastatic renal cell carcinoma: bevacizumab in combination with interferon-alpha2a compared with sunitinib. Br J Cancer 2010; 102: 80-6. https://doi.org/10.1038/sj.bjc.6605417