a new payment by results method for determining the fair price of new oncological drugs

The high prices of new cancer drugs are likely to undermine national health services sustainability. As a solu tion to this problem, the "payment-by-results" method was proposed and nowadays this approach is commonly implemented by national drug agencies: the drug manufacturer is set to refund to the National Health Service the price of the drug if the benefits expected for the patient are not achieved. Based on the payment-by-results approach, we developed a new and easy to implement model, that can set a fair price, so that neither industry, nor National Health Service can obtain an undue gain. Obviously, this price can be modified by adjusting refund amounts to new healthcare and market conditions

Is There a Role for Multiple Lines of Anti-HER2 Therapies Administered Beyond Progression in HER2-Mutated Non-Small Cell Lung Cancer? A Case Report and Literature Review

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RET Rearrangement as a Predictor of Unresponsiveness to Immunotherapy in Non-Small Cell Lung Cancer: Report of Two Cases with Review of the Literature

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Effectiveness of a phone-based nurse monitoring assessment and intervention for chemotherapy-related toxicity: A randomized multicenter trial

PurposeAnticancer treatment-related toxicities can impact morbidity and mortality, hamper the administration of treatment, worsen the quality of life and increase the burden on the healthcare system. Therefore, their prompt identification is crucial. NICSO (Italian Network for Supportive Care in Cancer) conducted a nationwide randomized trial to evaluate the role of a planned, weekly phone-based nurse monitoring intervention to prevent and treat chemotherapy, targeted therapy- and immunotherapy-related toxicities. Here, we report the results from the chemotherapy arm. MethodsThis was a nationwide, randomized, open-label trial conducted among 29 Italian centers (NCT04726020) involving adult patients with breast, colon, or lung cancer and a life expectancy >= 6 months receiving adjuvant chemotherapy. Patients received either a weekly nurse monitoring phone call and an educational leaflet reporting practical advice about prevention and treatment of toxicities (experimental group) or the educational leaflet only (control group). ResultsThe addition of a nurse monitoring intervention may help reduce time spent with severe toxicities (grade >= 3), particularly those less frequently reported in clinical practice, such as fatigue. When considering grade 1-2 AEs, times with mild/moderate diarrhea, mucositis, fatigue and pain were shorter in the experimental arm. Time spent without AEs was significantly longer in the experimental arms for all the toxicities. The requirement for special medical attention was comparable between groups. ConclusionThis study suggests the need for implementing a better system of toxicity assessment and management for patients treated with adjuvant chemotherapy to promote effective preventive and/or therapeutic intervention against these events

Management of chemotherapy induced emesis

Important progress has been achieved in the last few years in the prevention of chemotherapy-induced nausea and vomiting thanks to the introduction in clinical practice first of the 5-HT3 antagonists and of the NK1 antagonists more recently. To prevent acute emesis induced by cisplatin, moderately emetogenic chemotherapy, a combination of aprepitant plus a 5-HT3 antagonist and dexamethasone is now the most efficacious regimen. For the prevention of delayed emesis induced by cisplatin, moderately emetogenic chemotherapy, a combination of dexamethasone plus aprepitant or metoclopramide or a 5- HT3 antagonist / dexamethasone or a 5-HT3 antagonist are the preferred antiemetic regimens. For the prevention of acute emesis induced by low emetogenic chemotherapy a prophylaxis with a single antiemetic drug such as dexamethasone is suggested while no antiemetic prophylaxis should be administered to prevent acute emesis induced by minimal emetogenic chemotherapy or to prevent delayed emesis induced by low or minimal emetogenic chemotherapy. In this last case a rescue therapy should be administered in patients presenting acute or delayed emesis

Impact of Nausea and Vomiting on Quality of Life in Cancer Patients During Chemotherapy

Abstract It is commonly claimed that the nausea and vomiting accompanying cytotoxic chemotherapy have a negative impact on health-related quality of life. While this may seem self-evident, until a few years ago there was little empirical data demonstrating that the failure to control postchemotherapy emesis affects aspects of quality of life. In spite of their limitations, several observational studies showed that nausea and vomiting associated with chemotherapy induced a decrease in health-related quality of life with respect to patients without nausea and vomiting. This has also been demonstrated after the adjustment for health-related quality of life before chemotherapy that is an important prognostic factor of chemotherapy-induced nausea and vomiting. Furthermore, one study suggests that the optimal time of assessment of quality of life to evaluate the impact of chemotherapy-induced nausea and vomiting is day 4 if a 3-day recall period is used or day 8 when the recall period is 7 days. In double-blind studies the efficacy, tolerability and impact on quality of life of the 5-HT3 receptor antagonists was superior with respect to metoclopramide, alizapride and prochlorperazine. Similar results have been achieved with the combination of ondansetron with dexamethasone, the standard treatment for the prevention of acute emesis induced by moderately emetogenic chemotherapy, with respect to the metoclopramide plus dexamethasone combination. Instead, in another double-blind study, in patients submitted to moderately emetogenic chemotherapy, a 5-HT3 antagonist did not seem to significantly increase complete protection from delayed emesis and the patients' quality of life with respect to dexamethasone alone. In conclusion, the evaluation of quality of life in randomized trials comparing different antiemetic drugs for the prevention of chemotherapy-induced nausea and vomiting can add important information useful for the choice of the optimal antiemetic treatment.</p

SYMPOSIUM ARTICLE UDC: 616-006:615-085:612.064

Management of chemotherapy induced emesi

SYMPOSIUM ARTICLE UDC: 618.2-082:611.013.8:615.07

Management of chemotherapy induced emesi