Multicenter observational study on adherence and acceptance of lapatinib treatment in patients with HER2+ metastatic breast cancer.

Addeo, Raffaele; Vincenzi, Bruno; Riccardi, Ferdinando; Febbraro, Antonio; Maiorino, L.; Incoronato, Pasquale; Mabilia, Roberto; Bianco, M.; Russo, E.; Pisano, Agata; Prete, S. Del

doi:10.1200/jco.2011.29.15_suppl.e11102

Cited by 2 publications

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“…52 Interestingly, adherence to other oral therapies used in the treatment of breast cancer has been reported to be higher than that measured with hormonal therapies. 21,[27][28][29][30] It is unclear whether this variation is due to differences in methodology, treatment plan, breast cancer status, or a combination of these factors.…”

Section: Breast Cancermentioning

confidence: 99%

“…A recent systematic review regarding the use of adjuvant hormonal therapy in clinical practice showed that the prevalence of adherence over periods greater than 4 years ranged from 41% to 72%; the rate of discontinuation ranged from 31% to 73%, measured at the end of 5 years of therapy . Interestingly, adherence to other oral therapies used in the treatment of breast cancer has been reported to be higher than that measured with hormonal therapies . It is unclear whether this variation is due to differences in methodology, treatment plan, breast cancer status, or a combination of these factors.…”

Section: Studies Of Adherence To Oral Cancer Therapiesmentioning

confidence: 99%

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Improving Adherence to Oral Cancer Therapy in Clinical Practice

2014

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Adherence to oral chemotherapy regimens maximizes their effectiveness and minimizes any potential toxicities. Factors specifically related to the treatment, patient, and health care provider may influence medication adherence. Treatment‐related factors include the complexity of the regimen, the cost of therapy, the possibility of side effects, and the delay in treatment benefits. Meanwhile, patients may not have an adequate support system or an understanding of the need for the medication, and providers may not fully succeed in communicating the importance of adherence and the types of side effects that may occur. Nonadherence may lead to an increased risk of toxicity, decreased effectiveness, and increased utilization of health care resources. Although various methods for measuring adherence are available, self‐reporting is the most widely used. Studies describing adherence in a broad range of cancers are reviewed. Treatment of chronic myeloid leukemia has been revolutionized by the development of oral tyrosine kinase inhibitors that are highly effective in managing the disease when taken consistently. However, nonadherence is relatively common and can lead to reduced rates of response and increased medical costs. Similar effects of nonadherence on outcome and cost have also been observed in patients with various other hematologic malignancies and solid tumors. Interventions to improve adherence to oral chemotherapy regimens include communication about the importance of adherence and the potential consequences of nonadherence, simplification of the patient's medication schedule (if possible), and inclusion of a caregiver or family member in the conversation. Written materials should always be provided to accompany verbal instructions. This review summarizes factors influencing medication adherence, impact of nonadherence on patient outcomes, methods for measuring adherence, previous studies of nonadherence in patients with cancer, common barriers to access, and interventions to improve adherence in the community setting.

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Section: Breast Cancermentioning

confidence: 99%

Section: Studies Of Adherence To Oral Cancer Therapiesmentioning

confidence: 99%

Improving Adherence to Oral Cancer Therapy in Clinical Practice

2014

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“…Only 2 prior studies have reported such information. 14,15 In a study of 1816 patients participating in a patient assistance program (TYKERB CARES), mean medication possession ratio (MPR), a common measure of adherence in claims database analyses, was 91%; median time to end of continuous therapy (treatment interruption or discontinuation) was 3.8 months. 14 These data may not be representative of patients receiving lapatinib outside of such a program.…”

Section: Introductionmentioning

confidence: 99%

“…A prospective study of 69 Italian patients that assessed lapatinib adherence-based patient-completed medication diaries, selfreport during the physician interview, and the pharmacy control of the drug box reported that adherence to lapatinib was 82% across all cycles. 15 Although informative, these data may not be representative of patients receiving lapatinib in the United States. The objective of this study was to examine the prevalence, predictors, and clinical and economic consequences of nonadherence with lapatinib in women with MBC who were previously treated with trastuzumab, using data from a large US health insurance claims database.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Study of the Prevalence, Predictors, and Consequences of Nonadherence With Lapatinib in Women With Metastatic Breast Cancer Who Were Previously Treated With Trastuzumab

Delea

Kartashov

Sharma

2013

Journal of Pharmacy Technology

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Background. Lapatinib is an oral small molecule dual tyrosine kinase inhibitor that has been shown to improve time to progression versus capecitabine in women with HER2+ metastatic breast cancer (MBC) previously treated with trastuzumab. Objective. To describe extent, predictors, and consequences of nonadherence with lapatinib in women with MBC who were previously treated with trastuzumab. Methods. This was a retrospective observational study using data from a large health insurance claims databases spanning January 2000 to March 2010. Measures of lapatinib adherence included medication possession ratio (MPR), time to discontinuation (end of supply), time to first treatment interruption (gap during treatment of 30 days without supply), and duration of continuous therapy (time to gap of 30 days without supply or end of supply). Predictors of nonadherence to lapatinib and the association between nonadherence and outcomes, utilization, and costs were examined using multiple regression analysis. Results. A total of 666 patients met all inclusion criteria. Mean initial lapatinib dosage was 1161 mg daily; 63% received index lapatinib in combination with capecitabine. Mean MPR was 87%; 22% of patients had MPR < 80%. Median time to lapatinib discontinuation was 9.1 months (95% confidence interval = 8.0-10.2). Twenty-seven percent of patients had one or more treatment interruptions during follow-up. Median duration of continuous therapy was 5.9 months (95% confidence interval = 5.1-6.1). Concomitant therapy with a taxane was a predictor of nonadherence (odds ratio for MPR < 80% = 10.30; P < .001). There was a statistically significant association between nonadherence to lapatinib and greater number of outpatient visits (P = .028). Conclusions. In women with MBC who were previously treated with trastuzumab, mean adherence to lapatinib in typical clinical practice is relatively high overall, although there is a small group of patients with high nonadherence. Targeted efforts to improve adherence to lapatinib in this subgroup may be warranted.

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Multicenter observational study on adherence and acceptance of lapatinib treatment in patients with HER2+ metastatic breast cancer.

Cited by 2 publications

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Improving Adherence to Oral Cancer Therapy in Clinical Practice

Improving Adherence to Oral Cancer Therapy in Clinical Practice

Retrospective Study of the Prevalence, Predictors, and Consequences of Nonadherence With Lapatinib in Women With Metastatic Breast Cancer Who Were Previously Treated With Trastuzumab

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