What Affects Quality of Life Most in Oral Cancer Therapy? A Pilot Study of Adherence and Side Effects
Author(s)
Marina Daniela Dimulescu, PhD Student, Cristian Virgil Lungulescu, PhD, Mihaela-Simona Naidin, PhD, Andreea-Maria Gane, PhD Student, Ioana-Andreea Gheonea, PhD, Adina Turcu-Stiolica, PhD.
University of Medicine and Pharmacy of Craiova, Craiova, Romania.
University of Medicine and Pharmacy of Craiova, Craiova, Romania.
OBJECTIVES: Oral antineoplastics provide targeted therapy with improved convenience, but their optimal use requires precision oncology approaches. This study aimed to evaluate (1) medication adherence, (2) quality of life (QoL), and (3) adverse event (AE) burden among patients receiving different classes of oral antineoplastics, and to assess associations between these outcomes.
METHODS: A cross-sectional analysis of 58 patients receiving oral antineoplastics was conducted. Medications were categorized into three groups: I (targeted kinase-pathway inhibitors: TKAi, CDK4/6i, JAKi, PI3K/mTORi, MEKi, with similar once-daily schedules, overlapping adverse-event profiles-fatigue, rash, cytopenias), II (endocrine/hormonal therapies: NSAA, androgen-receptor inhibitors, aromatase inhibitors; all work by hormone-receptor blockade or deprivation; toxicities = hot flashes, arthralgias, sexual dysfunction), and III (classic cytotoxics/antimetabolites, with similar myelosuppressive and GI toxicity patterns; often given on fixed-cycle schedules). Outcomes included adherence (MARS questionnaire, range 0.1-1), QoL (15D instrument, range 0.1-1), and AE burden (weighted CTCAE score). Kruskal-Wallis tests compared outcomes across groups, and multivariable regression assessed predictors of QoL.
RESULTS: Mean age was 61.1±9.6 years; 63.8% were female. Breast (43.1%), colorectal (12.1%), and hematologic (10.3%) cancers were most common. QoL was inversely correlated with AE burden in Group I (Spearman’s ρ=−0.629, p<0.001) but not in Groups II (ρ=−0.037, p=0.914) or III (ρ=−0.419, p=0.301). Adherence was high across groups (Group I: 0.83±0.1; Group II: 0.84±0.09; Group III: 0.78±0.14) and unrelated to QoL or AEs. In the adjusted model, each CTCAE grade ≥2 toxicity reduced QoL by 0.016 units (β=−0.40, p=0.001). Adherence showed a non-significant positive trend with QoL (β=0.15, p=0.201).
CONCLUSIONS: AE burden independently predicted diminished QoL, particularly for kinase inhibitors, while adherence remained high across groups. Proactive toxicity management may be critical to preserving QoL in patients receiving oral antineoplastics, underscoring the need for tailored supportive interventions.
METHODS: A cross-sectional analysis of 58 patients receiving oral antineoplastics was conducted. Medications were categorized into three groups: I (targeted kinase-pathway inhibitors: TKAi, CDK4/6i, JAKi, PI3K/mTORi, MEKi, with similar once-daily schedules, overlapping adverse-event profiles-fatigue, rash, cytopenias), II (endocrine/hormonal therapies: NSAA, androgen-receptor inhibitors, aromatase inhibitors; all work by hormone-receptor blockade or deprivation; toxicities = hot flashes, arthralgias, sexual dysfunction), and III (classic cytotoxics/antimetabolites, with similar myelosuppressive and GI toxicity patterns; often given on fixed-cycle schedules). Outcomes included adherence (MARS questionnaire, range 0.1-1), QoL (15D instrument, range 0.1-1), and AE burden (weighted CTCAE score). Kruskal-Wallis tests compared outcomes across groups, and multivariable regression assessed predictors of QoL.
RESULTS: Mean age was 61.1±9.6 years; 63.8% were female. Breast (43.1%), colorectal (12.1%), and hematologic (10.3%) cancers were most common. QoL was inversely correlated with AE burden in Group I (Spearman’s ρ=−0.629, p<0.001) but not in Groups II (ρ=−0.037, p=0.914) or III (ρ=−0.419, p=0.301). Adherence was high across groups (Group I: 0.83±0.1; Group II: 0.84±0.09; Group III: 0.78±0.14) and unrelated to QoL or AEs. In the adjusted model, each CTCAE grade ≥2 toxicity reduced QoL by 0.016 units (β=−0.40, p=0.001). Adherence showed a non-significant positive trend with QoL (β=0.15, p=0.201).
CONCLUSIONS: AE burden independently predicted diminished QoL, particularly for kinase inhibitors, while adherence remained high across groups. Proactive toxicity management may be critical to preserving QoL in patients receiving oral antineoplastics, underscoring the need for tailored supportive interventions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR267
Topic
Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology