Adherence to abiraterone or enzalutamide in elderly metastatic castration-resistant prostate cancer.
Aged
Aged, 80 and over
Androstenes
/ administration & dosage
Benzamides
Cohort Studies
Humans
Male
Medication Adherence
Middle Aged
Neoplasm Metastasis
Nitriles
Phenylthiohydantoin
/ administration & dosage
Prospective Studies
Prostatic Neoplasms, Castration-Resistant
/ drug therapy
Treatment Outcome
Abiraterone
Adherence
Compliance
Elderly
Enzalutamide
Prostate cancer
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
23
10
2019
accepted:
14
01
2020
pubmed:
22
1
2020
medline:
22
10
2020
entrez:
22
1
2020
Statut:
ppublish
Résumé
To evaluate adherence to abiraterone or enzalutamide for the treatment of metastatic castration-resistant prostate cancer (mCRPC). In an observational prospective cohort study, we monitored patients with mCRPC for their adherence to abiraterone or enzalutamide in the pre- or post-chemotherapy setting. Fifty-eight patients with median age of 76 years (range 56-94), age-adjusted Charlson comorbidity score of 10 (range, 4-15), and geriatric G8 score of 14 (range, 6-17) were enrolled. Twenty-two (38%) patients were treated with abiraterone and 36 (62%) with enzalutamide, while forty-two (72%) were in the pre-chemotherapy setting. Forty-seven patients (81%) had a caregiver. Based on the pill counting, a non-adherence rate of 4.8% and 6.2% was observed for the whole period and the first 3 months, respectively, without a statistically significant difference between abiraterone and enzalutamide cohorts. A lower non-adherence rate (1.3%) was reported by patients during the whole period, mainly due to a misperception (77%) and forgetfulness (19%). Non-adherence rate to the fulfilling of the clinical diary was 38% for the whole period. Non-adherence in the whole period was related to the radiological response (p = 0.03) and geriatric G8 score (p = 0.005). By the receiver operating characteristic (ROC) curve based on the radiological response, non-adherence cut-off was 1.87% (p = 0.04). By this non-adherence cut-off, the G8 cut-off was 14.75 (p = 0.0003). Non-adherence to abiraterone or enzalutamide for mCRPC may have an impact on disease response and be related to patients' frailty, suggesting their geriatric assessment and clinical interventions to monitor and increase their adherence.
Identifiants
pubmed: 31960124
doi: 10.1007/s00520-020-05311-5
pii: 10.1007/s00520-020-05311-5
doi:
Substances chimiques
Androstenes
0
Benzamides
0
Nitriles
0
Phenylthiohydantoin
2010-15-3
enzalutamide
93T0T9GKNU
abiraterone
G819A456D0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
4687-4695Références
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