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RESEARCH PRODUCT

Treatment Monitoring Program for Implementation of Adherence to Second-Line Erlotinib for Advanced Non–Small-Cell Lung Cancer

Giuseppe Luigi BannaFrancesco FerraùPaolo TralongoNicolò BorsellinoMassimo BellaviaP. RussoVittorio Gebbia

subject

AdultMalePulmonary and Respiratory MedicineCancer Researchmedicine.medical_specialtyLung NeoplasmsVisual analogue scaleAdenocarcinomaMedication AdherenceErlotinib HydrochlorideCarcinoma Non-Small-Cell LungInternal medicinemedicineHumansErlotinib HydrochlorideProtein Kinase InhibitorsSurvival rateAgedNeoplasm StagingRetrospective StudiesAged 80 and overSalvage Therapybusiness.industryHealth Plan ImplementationRetrospective cohort studyAdenocarcinoma Bronchiolo-AlveolarMiddle AgedPrognosisSmall Cell Lung CarcinomaMonitoring programConfidence intervalSurgerySurvival RateOncologyCohortQuinazolinesCarcinoma Large CellPatient ComplianceFemaleErlotinibDrug MonitoringbusinessFollow-Up Studiesmedicine.drug

description

Abstract Background Adherence to erlotinib could be a determinant for clinical outcome and treatment toxicity in patients with advanced non–small-cell lung cancer (A-NSCLC). Patients and Methods In an observational study, the Basel Assessment of Adherence Scale (BAAS), a visual analogue scale (VAS), pill counting, and missed appointment rate were used to evaluate adherence in a first cohort of patients who was prescribed erlotinib without a specifically designed management strategy and in a second cohort of patients followed by an oral treatment monitoring program. Results Adherence > 95% by BAAS at 2 months of treatment in the first and second cohorts was 72% and 84%, respectively ( P = .042). Adherence by pill counting was 78% and 87% in the first and second cohorts, respectively ( P = .0021). Disease control rate (DCR) (complete response [CR] + partial response [PR] + stable disease [SD]) was significantly higher in all patients whose adherence by BAAS at 2 months was ≥ 95% ( P = .0266). DCR was higher in the second cohort compared with the first, being 63% (95% confidence interval [CI], 53%-72%) and 44% (95% CI, 30%-58%) in the second and the first cohort, respectively ( P = .0368). A significant correlation between the number of adverse events and patient-reported adherence was observed ( r = 0.105; P = .0001). Conclusion Nonadherence may be related to poorer rates of response to erlotinib. Effective interventions to reduce nonadherence need to be implemented.

yearjournalcountryeditionlanguage
2012-09-21Clinical Lung Cancer
https://doi.org/10.1016/j.cllc.2012.11.007