Predictors of oral anti-cancer agent utilisation in renal cell carcinoma

Patients who are older, frail, and have a higher comorbidity burden are less likely to use oral anti-cancer agents (OAAs) compared with younger, more fit patients with fewer comorbidities.

Prof. Stephanie Wheeler (University of North Carolina, USA) shared the results of her team’s investigation into the use of OAAs [1]. First, they note that OAAs offer several advantages; they are less invasive than intravenously administered drugs and they offer greater convenience and flexibility regarding location of administration. However, the use of OAAs also has potential disadvantages, including the risk of interactions with food or other drugs, difficulty in taking the agent due to odynophagia (i.e. painful swallowing), risk of missed doses, and, typically, increased cost.

The investigators sought to identify which patients would be more likely to adopt the use of OAAs following a diagnosis of metastatic renal cell carcinoma (mRCC). They retrospectively analysed data from the records of 713 patients contained in a registry-linked, multi-payer claims database to discover patterns associated with use of multiple OAAs (i.e. axitinib, cabozantinib, everolimus, lenvatinib, pazopanib, sorafenib, and sunitinib). All patients had been diagnosed with mRCC and were only included if they had been enrolled in the database for ≥12 months after diagnosis.

Unadjusted and adjusted risk ratios and 95% confidence limits were estimated for associations between use of OAAs and certain patient characteristics. Results demonstrated only a 37% usage of OAAs by the patients. Moreover, there was a definite trend towards lower uptake by patients who were older, frail, and had a greater burden of comorbidities. Other patient characteristics such as sex, race/ethnicity, urban versus rural, or public versus private insurance proved not to be predictive of OAA use.

More research into these patterns is warranted so that decisions regarding highest quality patient care can be guided by appropriate guiding principles.

1. Wheeler S. Patterns and predictors of oral anticancer agent utilization in diverse metastatic renal cell carcinoma patients. Abstract 279, ASCO Genitourinary Cancers Symposium, 11-13 February 2021.

 

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Posted on 24 March 202118 June 2021