Publication: Estudio farmaco-económico y de efectividad del esquema bevacizumab-irinotecan en el tratamiento de las recurrencias del glioblastoma multiforme primario frente a otras líneas de tratamiento
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2017-07-18
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Peña Díaz, Jaime
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Universidad Complutense de Madrid
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Abstract
El glioblastoma multiforme es un tipo de cáncer que afecta a las células de la glía del sistema nervioso central. Según el último informe del Central Brain Tumor Registry of the United States, el glioblastoma fue el tipo de tumor cerebral primario más diagnosticado en EEUU en los años 2007-2011. Constituye el tumor maligno primario más agresivo en adultos, siendo de resolución fatal. La prevalencia de la enfermedad es mayor en hombres que en mujeres con un ratio hombres/mujeres de 1, 6. A pesar de los numerosos avances científicos, la mediana de supervivencia para estos pacientes con únicamente el tratamiento estándar (resección quirúrgica, radioterapia (RT) y Temozolomida (TMZ) seguida de TMZ de mantenimiento durante 6 ciclos) sigue siendo baja, manteniéndose alrededor de los 14 meses. En el caso de las recurrencias a esa primera línea, no hay a día de hoy en Europa ningún tratamiento aprobado. La utilización de Bevacizumab+Irinotecan (BVZ/CPT-11) en GBM, se basa en la alta vascularización de este tipo de tumores y en datos preclínicos que demuestran la dependencia del crecimiento del glioma con la generación de vasos sanguíneos asociados al tumor. Nuestro estudio se encuadra en la necesidad de conocer el coste-efectividad de la combinación BVZ/CPT-11, y calcular el coste incremental que supone la introducción de esta segunda línea en el tratamiento del GBM comparado con los registros históricos que disponemos de los pacientes no tratados en segunda línea con este esquema. Además de intentar hallar algún factor pronóstico que nos permita seleccionar los pacientes que más se beneficiarían de este tratamiento...
Glioblastoma multiforme is a type of cancer that affects the glial cells of the central nervous system (CNS). According to the latest report from the Central Brain Tumor Registry of the United States, glioblastoma was the most diagnosed type of primary brain tumour in the USA between 2007-2011. Furthermore, it is the most aggressive primary malignant tumour in adults, with a 100% fatality rate. The illness is more prevalent in men than in women, with a men/women ratio of 1.6. Despite numerous scientific advancements, the median survival time for these patients just with standard treatment (surgical resection, radiotherapy (RT) and Temozolomide (TMZ) followed by 6 cycles of maintenance TMZ) is still low, remaining at around 14 months. In the case of recurrences of this first line, at present there is no approved treatment in Europe. The use of Bevacizumab+Irinotecan (BVZ/CPT-11) in GBM is based on the high vascularisation of this type of tumour and in preclinical data that show the dependence of the growth of the glioma on the generation of blood vessels associated with the tumour. Our study focuses on the need to know the cost-effectiveness of the BVZ/CPT-11 combination, and calculate the incremental cost adjusted to the quality of life that the introduction of this second line of GBM treatment supposes, compared to the historical records that are available to us for patients who have not undergone second-line treatment with this regimen. Furthermore we tried to find prognostic factors that help us to select the patients who would most benefit from BVZ/CPT-11 treatment...
Glioblastoma multiforme is a type of cancer that affects the glial cells of the central nervous system (CNS). According to the latest report from the Central Brain Tumor Registry of the United States, glioblastoma was the most diagnosed type of primary brain tumour in the USA between 2007-2011. Furthermore, it is the most aggressive primary malignant tumour in adults, with a 100% fatality rate. The illness is more prevalent in men than in women, with a men/women ratio of 1.6. Despite numerous scientific advancements, the median survival time for these patients just with standard treatment (surgical resection, radiotherapy (RT) and Temozolomide (TMZ) followed by 6 cycles of maintenance TMZ) is still low, remaining at around 14 months. In the case of recurrences of this first line, at present there is no approved treatment in Europe. The use of Bevacizumab+Irinotecan (BVZ/CPT-11) in GBM is based on the high vascularisation of this type of tumour and in preclinical data that show the dependence of the growth of the glioma on the generation of blood vessels associated with the tumour. Our study focuses on the need to know the cost-effectiveness of the BVZ/CPT-11 combination, and calculate the incremental cost adjusted to the quality of life that the introduction of this second line of GBM treatment supposes, compared to the historical records that are available to us for patients who have not undergone second-line treatment with this regimen. Furthermore we tried to find prognostic factors that help us to select the patients who would most benefit from BVZ/CPT-11 treatment...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, leída el 19/12/2016