Fleshner Neil E, Alibhai Shabbir M H, Connelly Kim A, Martins Ilidio, Eigl Bernhard J, Lukka Himu, Aprikian Armen
Princess Margaret Cancer Centre, University of Toronto, 610 University Ave, Toronto, ON M5G 2M9, Canada.
University Health Network, University of Toronto, Toronto, ON, Canada.
Ther Adv Med Oncol. 2023 Mar 29;15:17588359231152845. doi: 10.1177/17588359231152845. eCollection 2023.
Orally administrated agents play a key role in the management of prostate cancer, providing a convenient and cost-effective treatment option for patients. However, they are also associated with adherence issues which can compromise therapeutic outcomes. This scoping review identifies and summarizes data on adherence to oral hormonal therapy in advanced prostate cancer and discusses associated factors and strategies for improving adherence.
PubMed (inception to 27 January 2022) and conference databases (2020-2021) were searched to identify English language reports of real-world and clinical trial data on adherence to oral hormonal therapy in prostate cancer using the key search terms 'prostate cancer' AND 'adherence' AND 'oral therapy' OR respective aliases.
Most adherence outcome data were based on the use of androgen receptor pathway inhibitors in metastatic castration-resistant prostate cancer (mCRPC). Self-reported and observer-reported adherence data were used. The most common observer-reported measure, medication possession ratio, showed that the vast majority of patients were in possession of their medication, although proportion of days covered and persistence rates were considerably lower, raising the question whether patients were consistently receiving their treatment. Study follow-up for adherence was generally around 6 months up to 1 year. Studies also indicate that persistence may drop further with longer follow-up, especially in the non-mCRPC setting, which may be a concern when years of therapy are required.
Oral hormonal therapy plays an important role in the treatment of advanced prostate cancer. Data on adherence to oral hormonal therapies in prostate cancer were generally of low quality, with high heterogeneity and inconsistent reporting across studies. Short study follow-up for adherence and focus on medication possession rates may further limit relevance of available data, especially in settings that require long-term treatment. Additional research is required to comprehensively assess adherence.
口服药物在前列腺癌的治疗中发挥着关键作用，为患者提供了一种方便且经济高效的治疗选择。然而，它们也存在依从性问题，这可能会影响治疗效果。本综述旨在识别并总结晚期前列腺癌患者口服激素治疗依从性的数据，并讨论相关因素及提高依从性的策略。
检索了PubMed（创刊至2022年1月27日）和会议数据库（2020 - 2021年），使用关键词“前列腺癌”、“依从性”、“口服治疗”或各自的别名，以识别关于前列腺癌口服激素治疗依从性的真实世界和临床试验数据的英文报告。
大多数依从性结果数据基于转移性去势抵抗性前列腺癌（mCRPC）中雄激素受体通路抑制剂的使用。采用了自我报告和观察者报告的依从性数据。最常见的观察者报告指标——药物持有率显示，绝大多数患者持有药物，尽管覆盖天数比例和持续率要低得多，这就引发了患者是否持续接受治疗的问题。依从性研究的随访时间一般为6个月至1年。研究还表明，随着随访时间延长，持续率可能会进一步下降，尤其是在非mCRPC患者中，而在需要多年治疗的情况下，这可能是一个问题。
口服激素治疗在晚期前列腺癌治疗中起着重要作用。前列腺癌口服激素治疗依从性的数据质量普遍较低，研究之间存在高度异质性且报告不一致。依从性研究随访时间短且关注药物持有率可能会进一步限制现有数据的相关性，尤其是在需要长期治疗的情况下。需要更多研究来全面评估依从性。
