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Over-adherence to capecitabine: a potential safety issue in breast and colorectal cancer patients.
- Source :
-
Cancer chemotherapy and pharmacology [Cancer Chemother Pharmacol] 2018 Aug; Vol. 82 (2), pp. 319-327. Date of Electronic Publication: 2018 Jun 15. - Publication Year :
- 2018
-
Abstract
- Purpose: The aim of the OCTO clinical study was to measure patients' adherence to capecitabine-based treatment.<br />Methods: A cohort of ambulatory patients treated with capecitabine monotherapy for either locally advanced or metastatic, breast or colorectal cancer was monitored for 6 cycles. Adherence was assessed in all patients by self-completed questionnaires on disease, pill-count and pharmacological dosage of FBAL (metabolite of capecitabine); and in half of the cohort by electronic medication event monitoring systems (MEMS™) recording the opening times of the device.<br />Results: Forty patients were enrolled between November 2008 and September 2011 and treated by capecitabine for an average of 4.75 cycles (range 1-6). Hand-foot syndrome (HFS) was the most frequently reported toxicity (35% patients), and to a lesser extent fatigue and/or asthenia (21%), nausea and/or vomiting (13%) and diarrhea (11%). In the MEMS™ cohort, 20 patients were included. Patients' adherence was excellent with very few missing occasions (23/2272 records). Close analysis of MEMS™ data revealed unexpected medication patterns, such as patients taking extra days of medication beyond planned cycle, patients taking extra doses per day and patients missing a day of dosing and "compensating" by taking extra the following day (N = 7, 18%). A trend was found between over-adherence and high-grade toxicity (grades 3 and/or 4): OR 4.74 [0.65-45.2], p = 0.13 and higher AUC (p = 0.16). There was a trend towards increased AUC of FBAL in over-adherent patients (p = 0.16).<br />Conclusion: Adherence to oral anticancer chemotherapy was found excellent in this population suggesting over-adherence to capecitabine and potential safety implications for outpatients' drugs.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic administration & dosage
Antimetabolites, Antineoplastic adverse effects
Breast Neoplasms psychology
Capecitabine adverse effects
Cohort Studies
Colorectal Neoplasms psychology
Female
Humans
Male
Middle Aged
Prospective Studies
Surveys and Questionnaires
Breast Neoplasms drug therapy
Capecitabine administration & dosage
Colorectal Neoplasms drug therapy
Medication Adherence
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0843
- Volume :
- 82
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cancer chemotherapy and pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 29948022
- Full Text :
- https://doi.org/10.1007/s00280-018-3612-x