Advances in Oral Oncolytic Agents for Breast Cancer and Recommendations for Promoting Adherence

Abstract

Hormone receptor positivity and early stage diagnosis are generally considered signs of good prognosis in breast cancer. However, breast cancer all too frequently can become resistant to hormone-based therapies, and women can experience recurrence of their breast cancer decades after the diagnosis of early stage disease. To address the therapeutic needs for advanced and metastatic hormone receptor–positive (HR+) and human epidermal growth factor receptor 2–negative (HER2−) breast cancer, a number of new drugs have been tested and approved for this indication, including the class of drugs that works as cyclin-dependent kinase (CDK) 4/6 inhibitors. These drugs, often combined with other hormone-based therapy, have demonstrated considerable success in clinical trials and are now being used widely in oncology practices. Because all of the currently approved CDK4/6 inhibitor agents (palbociclib, ribociclib, and abemaciclib) are given orally, issues of patient comprehension of and adherence to prescribed regimens should be at the forefront of practitioners’ concerns about these drugs. In addition, ways to support and facilitate decision-making by patients related to this class of agents and other therapies recently approved for the same indication require focused attention by health-care providers. Oncology has continued to move toward a more patient-specific, precision medicine approach. Likewise, advanced practitioners have the opportunity to identify patient characteristics, preferences, and needs that are unique to individual patients to enhance precision treatment.

Features of Cancer mHealth Apps and Evidence for Patient Preferences: Scoping Literature Review

“…Some cancers, such as chronic leukemia and ovarian cancer can be managed, sometimes described as “controlled,” in a state where the cancer does not grow but is also not cured for months or years. Additionally, oral anticancer therapies, as opposed to intravenous chemotherapy, are now available for an increasing number of cancer indications [ 4 , 5 ]. These oral treatments are typically self-administered by the patient outside of the clinical setting, presenting challenges (eg, symptom and side effect management) for patients, their families, and their caregivers [ 6 - 8 ].…”

Features of Cancer mHealth Apps and Evidence for Patient Preferences: Scoping Literature Review (Preprint)

“…Some cancers, such as chronic leukemia and ovarian cancer can be managed, sometimes described as "controlled," in a state where the cancer does not grow but is also not cured for months or years. Additionally, oral anticancer therapies, as opposed to intravenous chemotherapy, are now available for an increasing number of cancer indications [4,5]. These oral treatments are typically self-administered by the patient outside of the clinical setting, presenting challenges (eg, symptom and side effect management) for patients, their families, and their caregivers [6][7][8].…”

Is Medication-Related Osteonecrosis of the Jaws (MRONJ) Associated to Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors? A Word of Cautiousness. Comment on Marcianò et al. Medication-Related Osteonecrosis of the Jaws and CDK4/6 Inhibitors: A Recent Association. Int. J. Environ. Res. Public Health 2020, 17, 9509

“…They act on the CDK-RB1-E2F pathway which is disrupted in cancer cells, and they are prescribed alone or, more often, together with drugs which prevent the downstream estrogen-dependent stimulation of cancer cells in most breast cancers [ 8 ]. They have been tested and approved for the treatment of estrogen-dependent HER2-negative metastatic breast cancer patients [ 9 , 10 , 11 ].…”