High adherence seen for oral metastatic renal cell carcinoma agents

Key Points

Chicago-Patients being treated with oral anticancer drugs for metastatic renal cell carcinoma (mRCC) demonstrate almost full adherence to their medication regimen, according to the first results of a prospective, observational, multicenter study from Belgium.

The study, initial results of which were presented at the American Society of Clinical Oncology annual meeting in Chicago, has a planned enrollment of 100 patients and is collecting data at baseline and through 1 year of follow-up. First author Pascal Wolter, MD, presented the findings on behalf of his co-investigators for 49 patients enrolled at 11 centers with a median follow-up of 131 days. The study sites include both academic and nonacademic practices, and the patients were predominantly male (67%), with a wide age range (25 to 87 years; median, 63 years).

Sunitinib (Sutent) was the most common medication prescribed (43%); other drugs represented included pazopanib (Votrient), 31%; everolimus (Afinitor), 20%; and sorafenib (Nexavar), 6%. Two-thirds of the patients were receiving an oral anticancer drug as first-line medication and the rest were receiving it as second-line therapy, reported Dr. Wolter, a medical oncologist at the University Hospital in Leuven.

"To our knowledge, this is the first prospective trial assessing adherence with oral anticancer drugs in patients with mRCC, and we believe that our patient population, which was recruited from different clinical settings in both Dutch and French-speaking hospitals, is representative of 'real-life' mRCC patients in Belgium," said Dr. Wolter.

"Our positive results are in contrast to some previous reports that describe oncology patients having poor adherence with long-term oral anticancer treatment. However, our study group is relatively small, the follow-up still short, and we acknowledge that selection bias may have a role in our findings as perhaps centers and patients that consider adherence a problem were overrepresented in our trial. Our study is continuing, and we believe further research in this area is needed to identify how adherence to oral anticancer drugs might differ between clinical settings, among patients with different cultural or social backgrounds, in different health care systems, and depending on the drug and indication."

Patients participating in the prospective study are also completing a variety of other questionnaires, and the data are being analyzed to understand factors that could influence adherence. So far, results show that median scores on both the Extent of Information Desire questionnaire and the Functional Assessment of Cancer Therapy-General scale were high at baseline and significantly higher than after 1 and 3 months.

Patients 'likely very motivated'

"These data show our patients had very high interest overall in receiving information about their treatment and their condition and suggest they were likely very motivated," Dr. Wolter told Urology Times.

"The fact that nearly all patients asked to participate in the study consented provides further evidence of a high level of motivation. Furthermore, we found that 84% of patients were confident when they were enrolled in the study that their oral therapy would help."

Patients also completed the Patient Satisfaction with Cancer Treatment Education questionnaire, and the results showed high levels at 1 and 3 months, indicating that the clinical centers did a good job in providing counseling initially and during ongoing treatment, he noted.

Dr. Wolter has a consultant/advisory role with Bristol-Myers Squibb, GlaxoSmithKline, Novartis, and Pfizer; receives honoraria from Novartis and Pfizer; and receives research funding from Bayer, GlaxoSmithKline, Novartis, and Pfizer.