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Lookup NU author(s): Dr Pasquale RescignoORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© 2022 The Author(s). Published by Oxford University Press. Background: Novel androgen receptor signaling inhibitors for prostate cancer (PC) impose the burden of self-administration on older patients overwhelmed by the requirement of many other concomitant medications. Patients and Methods: This study evaluated the proportion of non-adherence in a 12-month follow-up period and the first 3 months to abiraterone (ABI) or enzalutamide (ENZ). In a prospective multicenter observational cohort study, patients with metastatic castration-resistant PC (mCRPC) aged ≥70 years receiving ABI or ENZ pre- or post-docetaxel were enrolled. Treatment monitoring included pill counting, a self-assessment questionnaire, and clinical diaries at each clinical visit. Non-adherence rates were based on proportions of missed/prescribed pills ratios by pill counting. Results: Overall, 234 patients were recruited with median age of 78 years (range, 73-82); 86 (37%) were treated with ABI, and 148 (63%) with ENZ. The median follow-up for adherence was seven monthly cycles (IQR: 4-12). The two cohorts were well balanced for baseline characteristics. The percentage of non-adherence by pill counting was slightly higher for ABI than ENZ (5.2% vs. 4.2%, P <. 001). By self-reporting, patients on ENZ tended to report more frequently than those with ABI forgetfulness as the reason for missing events (42% vs. 17%, P <. 001). A lower Geriatric G8 score correlated with non-adherence (P =. 004). Overall survival (OS) was 48.8 months. Patients on ABI had radiographic progression-free survival (rPFS) of 28.4 [24.2-32.5], while for ENZ patients, we reported a median rPFS of 23.1 [18.2-28.1] months. Conclusion: Physicians tend to treat older mCRPC patients with ENZ. Non-adherence rate is relatively low overall but can be higher with ABI than with ENZ and correlates with the Geriatric G8 score. Forgetfulness is a potential barrier for ENZ.
Author(s): Rescigno P, Maruzzo M, Rebuzzi SE, Murianni V, Cinausero M, Lipari H, Fratino L, Gamba T, De Giorgi U, Caffo O, Bimbatti D, Dri A, Mosca A, Giunta EF, Ermacora P, Vignani F, Msaki A, Bonifacio B, Lombardo V, Conteduca V, Basso U, Fornarini G, Banna GL
Publication type: Article
Publication status: Published
Journal: Oncologist
Year: 2022
Volume: 27
Issue: 12
Pages: E949-E956
Print publication date: 01/12/2022
Online publication date: 03/08/2022
Acceptance date: 24/06/2022
Date deposited: 08/11/2024
ISSN (print): 1083-7159
ISSN (electronic): 1549-490X
Publisher: Oxford University Press
URL: https://doi.org/10.1093/oncolo/oyac147
DOI: 10.1093/oncolo/oyac147
Data Access Statement: The data underlying this article will be shared on reasonable request to the corresponding author.
PubMed id: 35920559
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