Impact of the app-based, nurse-led [email protected] supportive care program on the dose intensity of targeted oral therapies in patients with metastatic kidney cancer: a retrospective multicenter observational study

This article was originally published here

Cancer Care Support. 2022 April 29. doi: 10.1007/s00520-022-07088-1. Online ahead of print.


BACKGROUND: Tyrosine kinase (TKI) inhibitors remain a cornerstone of metastatic kidney cancer (mRCC). Adverse events (AEs) may lead to dose reduction, and optimal management of AEs is necessary to maintain an effective dose intensity (DI). The aim of our study was to assess the impact of an app-based, nurse-led supportive care program on ID in patients with mCRC.

METHOD: This retrospective multicenter study (n=3) evaluated all consecutive patients with mCRC who entered the study [email protected] program, which consisted of weekly app-based patient assessment led by a home nurse for the first 3 months of taking TKI. Treatment patterns and modifications were described, and the mean DI (mDI) was calculated at the end of [email protected]

Results: Eighty-nine patients were included: 12 had sunitinib, 18 pazopanib, 12 axitinib and 47 cabozantinib. The median age was 69 years (60-76). TKIs were mainly initiated at standard doses except for cabozantinib (53% started at 40 mg/day); 71% had already received systemic treatment. Nine patients discontinued permanent treatment during the program. Thirty-two patients required ≥ 1 dose interruption and 29% experienced ≥ 1 Grade 3 AE of any type. The mDI (in mg/day) at 3 months was 34.4 ± 17.7 for sunitinib, 672.8 ± 144 for pazopanib, 8.6 ± 2.6 for axitinib and 40 (36-48 ) for cabozantinib. Fifty-five patients [68.75% (95% CI: 57-78%)] had an mDI ≥ to that reported in the literature. Overall survival at 12 months was 64.2% (95% CI: 55-75%).

CONCLUSION: The [email protected] allowed 68.75% of patients to maintain a high dose intensity after 3 months of treatment with TKI. The impact on survival outcomes needs to be assessed in randomized clinical trials.

PMID:35484315 | DO I:10.1007/s00520-022-07088-1

About Herbert L. Leonard

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