1. More than 5000 patients with metastatic melanoma in Europe per year do not have access to recommended first-line innovative treatments
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Ketty Peris, Lev V. Demidov, Lars Bastholt, J.-J. Grob, Paul Nathan, M. Banjin, M. Kukushkina, Alexandros Stratigos, A.M. Forsea, A. Ymeri, Matilda Bylaite-Bucinskiene, Christoph Hoeller, A. Zhukavets, V. Todorovic, G. Weinlich, Claus Garbe, K. Putnik, L. Kandolf Sekulovic, Piotr Rutkowski, M. Risteski, K. Kirov, Iris Zalaudek, J. Ocvirk, Reinhard Dummer, D. Herceg, J. Maric-Brozic, Helen Gogas, Ricardo Vieira, Judit Oláh, Ivana Krajsová, N. Babovic, L. De La Cruz Merino, C. Blank, Johan Hansson, Bart Neyns, Axel Hauschild, C. Lebbé, Laboratory of Molecullar and Cellular Therapy, Laboratory for Medical and Molecular Oncology, Clinical sciences, [Sekulovic, L. Kandolf] Mil Med Acad, Fac Med, Dept Dermatol, Belgrade, Serbia, [Peris, K.] Univ Cattolica Sacro Cuore, Inst Dermatol, Rome, Italy, [Hauschild, A.] Univ Hosp Schleswig Holstein UKSH, Dept Dermatol, Campus Kiel, Kiel, Germany, [Stratigos, A.] Univ Athens, Athens, Greece, [Gogas, H.] Univ Athens, Athens, Greece, [Grob, J. -J.] Hop la Timone, Serv Dermatol & Cancerol Cutanee, Marseille, France, [Nathan, P.] Mt Vernon Canc Ctr, Northwood, Middx, England, [Dummer, R.] Univ Hosp, Univ Spital Zurich, Skin Canc Ctr, Zurich, Switzerland, [Forsea, A. -M.] Carol Davila Univ Med & Pharm, Elias Univ Hosp Bucharest, Bucharest, Romania, [Hoeller, C.] Med Univ Vienna, Dept Dermatol, Vienna, Austria, [Demidov, L.] NN Blokhin Russian Canc Res Ctr, Moscow, Russia, [Lebbe, C.] Hosp St Louis, APHP, Paris, France, [Blank, C.] Netherland Canc Inst, Amsterdam, Netherlands, [Olah, J.] Univ Szeged, Dept Dermatol & Allergol, Szeged, Hungary, [Bastholt, L.] Odense Univ Hosp, Dept Oncol, Odense, Denmark, [Herceg, D.] Univ Hosp Zagreb, Dept Oncol, Zagreb, Croatia, [Neyns, B.] VUB, Univ Ziekenhuis Brussel, Dept Med Oncol, Brussels, Belgium, [Vieira, R.] Univ Coimbra, Fac Med, Dept Dermatol, Coimbra, Portugal, [Hansson, J.] Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden, [Hansson, J.] Karolinska Univ Hosp Solna, Stockholm, Sweden, [Rutkowski, P.] Maria Sklodowska Curie Mem Canc Ctr, Warsaw, Poland, [Rutkowski, P.] Inst Oncol, Warsaw, Poland, [Krajsova, I.] Gen Teaching Hosp, Prague, Czech Republic, [Bylaite-Bucinskiene, M.] Vilnius Univ, Dept Dermatol, Vilnius, Lithuania, [Zalaudek, I.] Med Univ Graz, Div Dermatol & Venerol, Graz, Austria, [Maric-Brozic, J.] Univ Hosp Ctr Sestre Milosrdnice, Zagreb, Croatia, [Babovic, N.] Inst Oncol & Radiol Serbia, Belgrade, Serbia, [Banjin, M.] Univ Hosp Sarajevo, Dept Oncol, Sarajevo, Bosnia & Herceg, [Putnik, K.] North Estonia Med Ctr, Tallinn, Estonia, [Weinlich, G.] Med Univ Innsbruck, Dept Dermatol & Venerol & Allergy, Innsbruck, Austria, [Todorovic, V.] Clin Oncol & Radiotherapy, Podgorica, Montenegro, [Kirov, K.] Natl Canc Ctr, Clin Oncodermatol, Sofia, Bulgaria, [Ocvirk, J.] Inst Oncol Ljubljana, Ljubljana, Slovenia, [Zhukavets, A.] NN Alexandrov Natl Canc Ctr Belarus NCCB, Minsk, BELARUS, [Kukushkina, M.] Natl Canc Inst, Kiev, Ukraine, [De La Cruz Merino, L.] Hosp Univ Virgen Macarena, Dept Clin Oncol, Seville, Spain, [Ymeri, A.] Univ Hosp Mother Theresa, Tirana, Albania, [Risteski, M.] Univ Clin Radiotherapy & Oncol, Skopje, Macedonia, [Garbe, C.] Eberhard Karls Univ Tubingen, Dept Dermatol, Ctr Dermatooncol, Tubingen, Germany, Kandolf Sekulovic, L., Peris, K., Hauschild, A., Stratigos, A., Grob, J. -J., Nathan, P., Dummer, R., Forsea, A. -M., Hoeller, C., Gogas, H., Demidov, L., Lebbe, C., Blank, C., Olah, J., Bastholt, L., Herceg, D., Neyns, B., Vieira, R., Hansson, J., Rutkowski, P., Krajsova, I., Bylaite-Bucinskiene, M., Zalaudek, I., Maric-Brozic, J., Babovic, N., Banjin, M., Putnik, K., Weinlich, G., Todorovic, V., Kirov, K., Ocvirk, J., Zhukavets, A., Kukushkina, M., De La Cruz Merino, L., Ymeri, A., Risteski, M., and Garbe, C.
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Human development index ,Male ,Cancer Research ,Skin Neoplasms ,Survival ,medicine.medical_treatment ,Access ,Health expenditure per capita ,Immunooncology ,Innovative medicines ,Metastatic melanoma ,Targeted therapy ,Treatment ,Acrylonitrile ,Aniline Compounds ,Antibodies, Monoclonal, Humanized ,Europe ,Female ,Health Services Accessibility ,Healthcare Disparities ,Humans ,Immunotherapy ,Melanoma ,Programmed Cell Death 1 Receptor ,Proto-Oncogene Proteins B-raf ,Reimbursement Mechanisms ,Therapies, Investigational ,Oncology ,Investigational ,Reimbursement Mechanism ,Melanoma/economics ,Disparities ,Immuno oncology ,Medicines ,0302 clinical medicine ,Diagnosis ,Health care ,Monoclonal ,030212 general & internal medicine ,Healthcare Disparities/economics ,Acce ,Acrylonitrile/analogs & derivatives ,Humanized ,Proto-Oncogene Proteins B-raf/antagonists & inhibitors ,Reimbursement ,Programmed Cell Death 1 Receptor/antagonists & inhibitors ,Aniline Compound ,Healthcare Disparitie ,Health Services Accessibility/economics ,030220 oncology & carcinogenesis ,Targeted therapy Health ,Innovative medicine ,Health-care ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,Treatment Immunooncology ,Human ,medicine.medical_specialty ,Reimbursement Mechanisms/statistics & numerical data ,Union ,Antibodies ,Europe/epidemiology ,Malignant-melanoma ,03 medical and health sciences ,Pharmacotherapy ,Internal medicine ,medicine ,Skin Neoplasm ,Human Development Index ,Mortality ,Therapies, Investigational/economics ,Skin Neoplasms/economics ,Health policy ,business.industry ,Cancer ,medicine.disease ,access ,innovative medicines ,metastatic melanoma ,treatment ,immunooncologytargeted therapyhealth expenditure per capita ,human development index ,Surgery ,Immunotherapy/economics ,Therapies ,Aniline Compounds/economics ,Skin cancer ,business ,Cancer incidence ,Antibodies, Monoclonal, Humanized/economics - Abstract
Background. Despite the efficacy of innovative treatments for metastatic melanoma, their high costs has led to disparities in cancer care among different European countries. We analysed the availability of these innovative therapies in Europeand estimated the number of patients without access to first-line recommended treatment per current guidelines of professional entities such as the European Society for Medical Oncology (ESMO), the European Organisation for Research and Treatment of Cancer (EORTC), the European Association of Dermato-Oncology (EADO), and European Dermatology Forum (EDF). Materials and methods Web-based online survey was conducted in 30 European countries with questions about the treatment schedules from 1st May 2015 to 1st May 2016: number of metastatic melanoma patients, registration and reimbursement of innovative medicines (updated data, as of 1st October 2016), percentage of patients treated and availability of clinical studies and compassionate-use programmes. Results The recommended BRAF inhibitor (BRAFi)+MEK inhibitor (MEKi) combination was both registered and fully reimbursed in 9/30 (30%) countries, and in 13/30 (43%) (all from Eastern Europe) not reimbursed. First-line immunotherapy with anti-PD1 antibodies was registered and fully reimbursed in 14/30 (47%) countries, while in 13/30 (43%) (all from Eastern Europe) not reimbursed. It was estimated that in Europe 19,600 patients with metastatic melanoma are treated, and 5238 (27%) do not have access to recommended first-line therapy. Significant correlation was found between human development index (HDI, UNDP report 2015), (r=0.662; p Previous article in issue
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- 2017