Adherence to oral therapies in metastatic castration resistance (m CRPC) prostate cancer patients: The ADOPTA study.

Abstract

e18014 Background: With the increasing use of oral anticancer treatments understanding adherence patterns and patient’s information about therapy has become critical. Enzalutamide (ENZ) and Abiraterone acetate (AA) are orally administered drugs approved for the treatment of mCRPC widely prescribed; however, scarce information is available about treatment compliance and patient’s information about these compounds. This study aims to evaluate the adherence to AA and ENZ and the patient’s drug knowledge in mCRPC patients. Methods: A 20-question survey is being delivered to patients with mCRPC receiving either AA or ENZ in 8 centers across Spain. Questions cover items such as demographics, drug information, adherence and perceived benefits among other topics. Surveying is still ongoing. Results: Fifty patients have completed the survey at this time. Mean age is 72 years (range 58-87), educational level is basic in 56 %. Median duration of treatment was 9,5 months. Adherence reported is very high with 84% of the patients taking 100% of prescribed doses and 100% more than 75%. Treatment compliance does not seem to decrease over time despite only 42% of the patients reported the use of devices to secure adherence. A high compliance correlated with better symptom control. Nonetheless, many areas of improvement have been also identified. About a quarter of the patients (26%) ignored the name of the drug they were receiving and 24% whether or not they were in a clinical trial. Almost all patients were not aware of the planned duration of treatment and 70 % recognized that they did not know the consequences of a bad adherence. Eleven patients (22%) were taking AA with food outside of a clinical trial and three patients (6%) reported inadequate dosage (i.e q 12h). Conclusions: While in other diseases adherence to oral therapies has been identified as a potential limiting factor with impact in efficacy, in our series of mCRPC treatment compliance was high and maintained overtime. Yet, serious patient education pitfalls were identified. Data collection is ongoing and further analysis will be presented.

Adherence to oral hormonal therapy in advanced prostate cancer: a scoping review

“…Four prospective 48,51,66,71 and nine retrospective studies 61–65,67–70 reported adherence outcomes for patients receiving ARATs for mCRPC (Table 2). Three used self-reported measures as the main adherence outcome 66,71 and 10 employed observer-reported measures. 48,61–65,67–70…”

“…The literature search identified a total of 694 records, resulting in a total of 16 eligible studies reporting results from assessment of adherence to oral therapies in prostate cancer patients (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Figure 1). In all, 13 observational studies assessed adherence and related measures exclusively in mCRPC patients (Table 2), 48,51,[61][62][63][64][65][66][67][68][69][70][71] while one phase III trial and two observational trials assessed adherence in advanced prostate cancer (Table 3). 14,53,72 Studies were mostly conducted in North America (n = 7) and Europe (n = 8) based on data from large national or provincial registries or hospital network databases (11), or smaller multi-or singlecenter analyses (5).…”

“…53,64 Although some suspect that male gender may be associated with poor adherence, inconsistent associations between gender and adherence have been observed in studies of hypertension. 86 The most common treatment-related factors negatively affecting adherence were earlier stage of disease (better prognosis), 72 treatment intolerance, 67 concomitant medication, 53 and lack of response to therapy or low symptom control, 48,66 although patients’ beliefs about ineffectiveness of therapy also had an impact. The most common schedule-related factors were increasing dose (number of tablets per day), 51 overall complexity of drug regimens, and higher cost.…”

“…Four prospective 48,51,66,71 and nine retrospective studies [61][62][63][64][65][67][68][69][70] reported adherence outcomes for patients receiving ARATs for mCRPC (Table 2). Three used self-reported measures as the main adherence outcome 66,71 and 10 employed observer-reported measures. 48,[61][62][63][64][65][67][68][69][70] A small prospective, multicenter, open-label, randomized controlled trial (RCT), 51 a large prospective multicenter study 71 and a small multicenter survey study assessed adherence using selfreported measures.…”

Advances in Transversal Topics Applicable to the Care of Bladder Cancer Patients in the Real-World Setting

“…Cancer patients are also at risk of food–drug interactions, and serious patient education pitfalls in understanding treatment compliance have been identified [ 33 ]. On the other hand, use of complementary and alternative medicine (CAM) has increased in the last decade in both palliative and curative settings, with different reasons argued by patients for the use of these compounds [ 34 , 35 ].…”