Patient preference for oral chemotherapy in the treatment of metastatic breast and lung cancer

Abstract

Objectives Although new therapies against metastatic cancer have been developed in recent decades, chemotherapy is still an important treatment option. Prolonged treatment and side‐effects are often discouraging for patients, and in many cases, therapy is only palliative, not curative. This study explores patient preference for oral or intravenous (IV) chemotherapy in the treatment of metastatic breast or lung cancer. Methods It is a descriptive, open label, multicentre, nation‐wide study, in which a 16‐item questionnaire consisting of single‐choice questions scored on a 5‐point Likert scale was administered to patients in a single visit, and another 11‐item questionnaire was self‐administered by the patient’s oncologist. Results A total of 131 breast and lung cancer specialists at 64 hospitals enrolled 412 patients (lung cancer = 161; breast cancer = 251). To be eligible, patients must have already received IV therapy and at least 2 cycles of oral chemotherapy. Most (77%) patients expressed preference for oral therapy. Most considered their daily life was less disrupted with tablets (70.4%), had no trouble swallowing them (86.9%), and were not concerned about forgetting to take them (56.8%). Half (56.3%) were worried about problems related to drug infusion with IV therapy, 61.7% were concerned about nurses failing to find a suitable vein, and 63.1% were dissatisfied with hospital waiting times. A uniform response was obtained from both samples of patients. Conclusion Convenience, ease of administration, fewer side effects and better quality of life tilt the balance towards oral drug administration.

The Use of Real-World Evidence for Oral Chemotherapies in Breast Cancer

“…Recently, Ciruelos and colleagues (2019) have confirmed that a majority of patients (77%) with breast or lung cancer preferred oral therapy due to less disruption of daily life, no trouble in swallowing oral therapy, and no issues with missing doses. This patient population had already received IV therapy and at least two cycles of oral chemotherapy, with 56.3% reporting problems related to drug infusion with IV therapy, 61.7% expressing concerns about nurses failing to find suitable veins, and 63.1% reporting dissatisfaction with hospital waiting times ( Ciruelos et al, 2019 ). In light of these data, an increasing number of oral chemotherapeutics are under development and are expected to become available soon ( Jibodh et al, 2013 ; Stuurman et al, 2013 ).…”

“…Several surveys and studies have reported an increased acceptance for oral drugs among patients and health-care professionals ( Ciruelos et al, 2019 ; Eek et al, 2016 ; Navarro et al, 2002 ; Schott et al, 2011 ). An analysis of previous studies indicates that most patients who have experienced oral agents do not favor IV chemotherapy and report a clear preference for oral chemotherapy for breast cancer treatment ( Eek et al, 2016 ).…”

Injectable Hypomethylating Agents for Management of Myelodysplastic Syndromes: Patients’ Perspectives on Treatment

“…[8][9][10] Inconvenience associated with treatments given as IV infusions or SC injections has also been identified as a barrier to adherence in other therapeutic areas, for which there are both injected and oral disease-modifying therapies available, with higher adherence and satisfaction reported by patients receiving oral therapies. Oral therapy typically offers multiple convenience advantages such as less disruption of daily life 11 and reduction in stress and discomfort associated with injectable treatments. 12 A recently approved oral form of HMA, a combination of decitabine with cedazuridine, 13 may be able to alleviate some of the challenges experienced by MDS patients (and caregivers) who receive HMA therapy via infusions/injections.…”

Hereditary angioedema patients would prefer newer-generation oral prophylaxis

“…For patients with psoriasis, treatment attributes focusing on convenience and lifestyle compatibility, i.e., treatment location and route of administration, were considered to be more important than adverse effects [17]. Several studies for cancer treatments have found oral treatments to be preferred over intravenous administration across a range of cancer patient populations citing a variety of reasons, including greater flexibility, convenience, less stress, and better quality of life [19][20][21][22][23][24].…”