Medical Oncology Department, Nuovo Ospedale-Santo Stefano, Instituto Toscano Tumori, Prato 59100, Italy; Cancer Clinical Trials Unit, Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA.
Cancer Treat Rev. 2017 Jun;57:58-66. doi: 10.1016/j.ctrv.2017.05.002. Epub 2017 May 15.
There is an increasing trend towards using oral systemic therapy in patients with cancer. Compared to parenteral therapy, oral cancer agents offer convenience, have similar efficacy, and are preferred by patients, consequently making its use appealing in older adults. However, adherence is required to ensure its efficacy and to avoid compromising treatment outcomes, especially when the treatment goal is curative, or in case of symptomatic/rapidly progressing disease, where dose-intensity is important. This opens a new challenge for clinicians, as optimizing patient adherence is challenging, particularly due to lack of consensus and scarcity of available clinical evidence. This manuscript aims to review the impact of age-related factors on adherence, summarize the evidence on adherence, recommend methods for selecting patients suitable for oral cancer agents, and advise monitoring interventions to promote adherence to treatment.
癌症患者越来越倾向于使用口服全身治疗。与胃肠外治疗相比,口服癌症药物具有使用方便、疗效相当、患者更易接受等优点,因此在老年患者中更具吸引力。然而,为了确保疗效并避免影响治疗结果,特别是在治疗目标是治愈或疾病处于有症状/快速进展阶段、需要剂量强度时,需要患者用药依从。这给临床医生带来了新的挑战,因为优化患者的依从性具有挑战性,特别是由于缺乏共识和临床证据有限。本文旨在回顾与年龄相关的因素对依从性的影响,总结关于依从性的证据,推荐选择适合口服癌症药物患者的方法,并就促进治疗依从性的监测干预措施提供建议。