A Multi-disciplinary Approach to Managing Chronic Myelogenous Leukemia Patients on Oral Anticancer Therapy at a Large Academic Medical Center

Canadeo, Angela; Fournogerakis, Mary; Zook, Felicia

doi:10.1007/s11899-021-00659-9

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Non-adherence to therapy is a key treatment-failure risk and a challenge for treating clinicians [61][62][63][64][65][66]. Anything less than complete adherence in patients treated with imatinib is associated with increased risk of a poor response [65].…”

Section: Risks Of Non-adherencementioning

confidence: 99%

“…However, lower adherence and overall survival were reported for women, those with lower health insurance and people aged over 70 years. Interestingly, the USA study [ 61 ] found a relationship between financial burden and adherence over time. The US lacks a universal health care scheme and the percentage of population in poverty is much higher than in the Organisation for Economic Co-operation and Development (OECD) countries (17% vs 9%) [ 71 ].…”

Section: Risks Of Non-adherencementioning

confidence: 99%

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Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication

Shahrin

Wadham

Branford

2022

Curr Hematol Malig Rep

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Purpose of Review The chronic myeloid leukemia (CML) treatment success story is incomplete as some patients still fail therapy, leading to end-stage disease and death. Here we discuss recent research into CML incidence, the role of comorbidities on survival and detecting patients at risk of failing therapy. Recent Findings The incidence of CML has fallen markedly in high social-demographic index (SDI) regions of the world but there is disturbing evidence that this is not the case in low and low-middle SDI countries. Now that CML patients more frequently die from their co-morbid conditions than from CML the Adult Comorbidity Evaluation-27 score can assist in risk assessment at diagnosis. Non-adherence to therapy contributes greatly to treatment failure. A good doctor-patient relationship and social support promote good adherence, but patient age, gender, and financial burden have negative effects, suggesting avenues for intervention. Mutations in cancer-associated genes adversely affect outcome and their detection at diagnosis may guide therapeutic choice and offer non-BCR::ABL1 targeted therapies. A differential gene expression signature to assist risk detection is a highly sought-after diagnostic tool being actively researched on several fronts. Summary Detecting patients at risk of failing therapy is being assisted by recent technological advances enabling highly sensitive genomic and expression analysis of insensitive cells. However, patient lifestyle, adherence to therapy, and comorbidities are critical risk factors that need to be addressed by interventions such as social and financial support.

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Section: Risks Of Non-adherencementioning

confidence: 99%

Section: Risks Of Non-adherencementioning

confidence: 99%

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication

Shahrin

Wadham

Branford

2022

Curr Hematol Malig Rep

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“…Structured OAA programmes have been set up in different countries and described in the literature, based on different components and organisation, 14 highlighting the follow-up and monitoring of patients throughout their treatment. 15 A promising effect has been described in the literature for certain adherence enhancing interventions, applied to target one or multiple factors influencing patient behaviour. 16 The management of side effects should be more specifically included in OAA care programmes in order to help patients better identify them and improve their self-care behaviour.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of the ONCORAL multidisciplinary programme for the management of outpatients taking oral anticancer agents at risk of drug-related event: protocol for a pragmatic randomised controlled study

Huot,

Guerre,

Descotes

et al. 2024

BMJ Open

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IntroductionThe development of oral anticancer agents (OAA) has profoundly changed cancer care, leading patients to manage their chemotherapy treatment on an outpatient basis. The prevention of iatrogenic effects of OAA remains a major concern, especially since their side effects are not less serious than those of intravenous chemotherapy. The ONCORAL programme was set up to secure the management of OAA in cancer patients followed at the Lyon University Hospital. This multidisciplinary programme involves hospital pharmacists, nurses, oncologists, and haematologists, as well as community health professionals. Given the economic stakes that this programme entails for the health system, a medico-economic study was designed.Methods and analysisThis is a prospective controlled study, with individual open-label randomisation. A total of 216 outpatients treated with OAA and at risk of developing a drug-related iatrogenic event, will be randomised (2:1) to undergo follow-up in the ONCORAL programme or usual care. The primary outcome will be the estimation of the incremental cost-effectiveness ratio (difference in total costs per quality adjusted life years gained) at 12 months between the two groups. The secondary outcomes will be evaluation of OAA management consequences (relative-dose intensity, adherence, adverse drug events, drug–drug interactions, and proven medication errors), evaluation of overall survival and cancer-related quality of life, and patient-reported outcomes in relation to the treatment. A budget impact analysis will be implemented. Patient and health professional satisfaction regarding the ONCORAL programme will be measured.Ethics and disseminationApproval to conduct this study was obtained from an Ethics Committee (Comité de Protection des Personnes Ile-de-France VI) in October 2019, and from the French data protection agency (Commission Nationale de l’Informatique et des Libertés), according to the French Law. Trial results will be disseminated at clinical conferences and published in peer-reviewed journals.Trial registrationNCT03660670.

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Maximizing the Value of Chronic Myeloid Leukemia Management Using Tyrosine Kinase Inhibitors in the USA: Potential Determinants and Consequences of Healthcare Resource Utilization and Costs, with Proposed Optimization Approaches

Lipton

2024

Clin Drug Investig

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A Multi-disciplinary Approach to Managing Chronic Myelogenous Leukemia Patients on Oral Anticancer Therapy at a Large Academic Medical Center

Cited by 4 publications

References 10 publications

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication

Cost-effectiveness of the ONCORAL multidisciplinary programme for the management of outpatients taking oral anticancer agents at risk of drug-related event: protocol for a pragmatic randomised controlled study

Maximizing the Value of Chronic Myeloid Leukemia Management Using Tyrosine Kinase Inhibitors in the USA: Potential Determinants and Consequences of Healthcare Resource Utilization and Costs, with Proposed Optimization Approaches

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