Adherence to treatment with imatinib in chronic myeloid leukemia: a study of the first decade of responses obtained at a Brazilian hospital

Reis, Samuel Roosevelt Campos dos; Quixadá, Acy Telles de Souza; Nunes, Sammara Tavares; Cid, Danielle Maria Camelo; Souza, Jacqueline Holanda de; Costa, Clara Maria Bastos Eloy da; Silva, Camila Silveira da; Cid, David Antonio Camelo; Oliveira, Mariana Fatima Cabral de

doi:10.5581/1516-8484.20130053

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…The low response rate in our cohort may be due to the delay between diagnosis and treatment. Incomplete adherence to the treatment is also likely to have an impact on the low response rates we observed, as several studies demonstrate that the poor adherence to the treatment is associated with a lower response in CML [22][23][24].…”

Section: Discussionmentioning

confidence: 80%

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

et al. 2016

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Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to specific treatment and the high cost of diagnosis and monitoring patients. The aim of this study was to report CML treatment response in a developing country in the tyrosine kinase inhibitor era. We conducted a longitudinal study of our cohort of CML patients. Socio-demographic, diagnosis, therapeutic, and treatment response parameters were studied. Sokal score, disease phase at diagnosis, delay from diagnosis to treatment, and treatment response were analyzed for their impact on survival. Fifty-five patients with a diagnosis of CML and who received treatment with imatinib for a minimum of 3 months were included in this study. Median follow-up was 170 patient-years. The sex ratio (M/F) was 1.62 and median age at diagnosis was 42 years. At diagnosis, 85.5 % of the patients were in chronic phase (CP), 12.7 % in accelerated phase (AP), and 1.8 % in blast crisis (BC). Sokal risk score distribution was as follows: low risk 29.8 %, intermediate risk 38.3 %, and high risk 31.9 %. Median time from first symptoms to first medical visit was 6.2 months and median time from first medical visit to cytogenetic and or molecular confirmation was 12.4 months. Mean delay time from first medical visit to imatinib initiation was 12.5 months (95 % CI 6.3-18.7). The complete hematologic response (CHR) at 3 months, the major cytogenetic response (MCR) at 12 months, and the major molecular response (MMR) at 24 months were respectively 82.4, 75, and 25 %. The 2-year overall survival rate was 81 %. Advanced phase at the diagnosis, discontinuation of imatinib therapy over 15 % of the time, lack of CHR at 3 months, lack of MCR at 12 months, and progression of the disease during imatinib therapy were associated with a risk of death (p ≤ 0.05). Our data confirm the improved prognosis of CML treated with imatinib in the setting of a developing country. However, response rates are lower than in developed countries, and additional efforts should be made to facilitate early diagnosis and improve access to TKI, treatment compliance, and regular molecular monitoring of patients.

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Section: Discussionmentioning

confidence: 80%

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

et al. 2016

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“…Real-world studies of oral anticancer agents show that substantial numbers of patients (20-47%) are nonadherent, 14,15,29,30 mainly due to AEs, and a lack of understanding by patients of the importance of taking their medication as prescribed. [14][15][16]29,30 The FCS program addresses both of these issues by promoting a collaborative approach to AE education and management, and facilitating co-operation and teamwork between pharmacists, physicians, nurses, and patients themselves.…”

Section: Introductionmentioning

confidence: 99%

Pharmacist-led patient education and adverse event management in patients with non-small cell lung cancer receiving afatinib in a community-based, real-world clinical setting

Khrystolubova

Shieh

Patel

et al. 2019

J Oncol Pharm Pract

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PurposeTo describe the outcomes of a pharmacist-led multi-center, collaborative patient education and proactive adverse event management program in a community-based oncology setting.MethodsPatients with EGFR mutation-positive (EGFRm+) non-small cell lung cancer, newly prescribed with oral afatinib, and monitored as part of the Florida Cancer Specialists patient management program, were included in a retrospective, observational analysis. During follow-up, data were collected on adverse event frequency, and changes in afatinib dosing. Data analyses were descriptive and exploratory in nature.ResultsThe mean age of the 123 patients included in the analysis was 69 years, and 78% were female. At the time of the analysis, 3 patients had discontinued before receiving treatment, 89 patients had discontinued afatinib treatment, and 31 patients were continuing to receive afatinib treatment. The most common afatinib-related adverse events were diarrhea (85%), rash/skin reactions (58%), stomatitis/mucositis (19%), and paronychia (16%). Overall, 13% of patients discontinued due to afatinib-related adverse events. The median duration of treatment was 4 months in patients who discontinued due to adverse events, 6 months in those who discontinued for other reasons, and 18 months in those who were continuing to receive therapy. Afatinib dose-reductions were more frequent in patients continuing treatment versus those who discontinued due to adverse events (77% vs. 42%, respectively).ConclusionsFindings suggest that adverse events in patients with EGFRm + non-small cell lung cancer receiving afatinib can be successfully managed in a community-based, real-world setting with the help of collaborative pharmacist-led patient education, adverse event monitoring, and continuous support.

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“…Among the 14 studies analyzed, seven referred only to adherence, one referred only to discontinuation, five assess adherence and discontinuation and one included only suboptimal adherers. It was evident that few studies have assessed the achievement of cytogenetic and molecular response, which are important parameters for analyzing the absence of Philadelphia chromosome, as well as reduced levels of BCL-ABL rearrangement (Marin et al, 2010;Cid et al, 2013;Reis et al, 2013). In addition, four studies showed adherence rates relatively low to imatinib, such as between 19.0 and 53.0%.…”

Section: Resultsmentioning

confidence: 99%

Adherence and/or discontinuation of imatinib mesylate in patients with chronic myeloid leukemia

Alves

Lima

Nagai

et al. 2016

Braz. J. Pharm. Sci.

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Adherence to treatment with imatinib in chronic myeloid leukemia: a study of the first decade of responses obtained at a Brazilian hospital

Cited by 9 publications

References 21 publications

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

Pharmacist-led patient education and adverse event management in patients with non-small cell lung cancer receiving afatinib in a community-based, real-world clinical setting

Adherence and/or discontinuation of imatinib mesylate in patients with chronic myeloid leukemia

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