Lung cancer drug therapy in Hungary – 3-year experience

Abstract

Judit Moldvay,1 György Rokszin,2 Zsolt Abonyi-Tóth,2 Lajos Katona,3 Katalin Fábián,4 Gábor Kovács5 1Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary; 2RxTarget Company Ltd, Szolnok, Hungary; 3Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; 4Department of Pulmonology, Semmelweis University, Budapest, Hungary; 5National Korányi Institute of Pulmonology and Tuberculosis, Budapest, Hungary Abstract: Hungary is a world leader in lung cancer deaths, so it is of crucial importance that patients have access to modern treatments. The aim of our analysis was to explore how drug treatments are used in Hungary and how they are compatible with international practice. The inpatient and prescription database of the National Health Insurance Fund Administration of Hungary was used to study the frequency of certain chemotherapy protocols and duration of therapies during a 3-year period (2008–2010). During the study period, 12,326 lung cancer patients received first-line chemotherapy, a third of those (n=3,791) received second-line treatment, and a third of the latter (n=1,174) received third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of non-small-cell lung carcinoma mainly consisted of platinum treatment in combination with third-generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with a significantly increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among the new agents, the use of pemetrexed and bevacizumab increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib appeared also in second-line but mostly in third-line treatments. The first-line treatment of small-cell lung carcinoma consisted of a platinum–etoposide combination, while in the second-line setting topotecan was the most commonly used drug. According to our results, the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain a more accurate picture of the efficacy of lung cancer treatments as well. Keywords: lung cancer, chemotherapy, molecularly targeted treatment, Hungarian practice