Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study

Abstract Purpose We aimed to evaluate adherence to oral antineoplastic therapy (OAT) in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and its potential relationship with several clinical outcomes. Methods Observational, prospective, multicenter study performed by 6...

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Main Authors: Irene Mangues-Bafalluy, Beatriz Bernardez, José Manuel Martínez-Sesmero, Andres Navarro-Ruiz, Maria Teresa Martín-Conde, Ana Rosa Rubio-Salvador, Judith Rius-Perera, Marta Gilabert-Sotoca, Marta Domínguez López, Angel Callejo Mellén
Format: Article
Language:English
Published: Springer 2025-08-01
Series:Journal of Cancer Research and Clinical Oncology
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Online Access:https://doi.org/10.1007/s00432-025-06264-0
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author Irene Mangues-Bafalluy
Beatriz Bernardez
José Manuel Martínez-Sesmero
Andres Navarro-Ruiz
Maria Teresa Martín-Conde
Ana Rosa Rubio-Salvador
Judith Rius-Perera
Marta Gilabert-Sotoca
Marta Domínguez López
Angel Callejo Mellén
author_facet Irene Mangues-Bafalluy
Beatriz Bernardez
José Manuel Martínez-Sesmero
Andres Navarro-Ruiz
Maria Teresa Martín-Conde
Ana Rosa Rubio-Salvador
Judith Rius-Perera
Marta Gilabert-Sotoca
Marta Domínguez López
Angel Callejo Mellén
author_sort Irene Mangues-Bafalluy
collection DOAJ
description Abstract Purpose We aimed to evaluate adherence to oral antineoplastic therapy (OAT) in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and its potential relationship with several clinical outcomes. Methods Observational, prospective, multicenter study performed by 6 hospital pharmacists in Spain. The primary outcome was the proportion of treatment adherence as evaluated by pill reconciliation during the 3-month active follow-up period. Those with an adherence > 80% were categorized as adherent. We performed multivariate Cox regression analyses to explore the factors associated with progression-free survival. Results From December 2019 to November 2022, we recruited 95 evaluable patients. Most of the patients received osimertinib (n = 45, 45.3%) or a first- or second-generation tyrosine kinase inhibitor (n = 23, 34.8%). Eighty-one patients showed greater than 80% adherence (85.3%, 95% CI 78.1% to 92.4%), as evaluated based on pill reconciliation; the mean (SD) adherence to OAT was 94.7% (11.4). According to the univariate analysis, the time to progression from study entry was significantly shorter among patients who were nonadherent than among those who were adherent (median 6.5 months vs. not reached, log-rank test p = 0.006; hazard ratio [HR] 2.619, 95% confidence interval [CI] 1.240–5.532). In the multivariate Cox regression analysis, nonadherence was the single factor associated with progression-free survival. Conclusion Consistent with previous evidence in this setting, our results suggest that adherence to oral antineoplastic treatment among patients with NSCLC is high. Whether this high rate of adherence translates to better clinical outcomes should be further evaluated in larger samples.
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spelling doaj-art-dc7f36cfd2b94fb5a915eb22df01280a2025-08-20T03:45:40ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-08-0115181910.1007/s00432-025-06264-0Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective studyIrene Mangues-Bafalluy0Beatriz Bernardez1José Manuel Martínez-Sesmero2Andres Navarro-Ruiz3Maria Teresa Martín-Conde4Ana Rosa Rubio-Salvador5Judith Rius-Perera6Marta Gilabert-Sotoca7Marta Domínguez López8Angel Callejo Mellén9Servicio de Farmacia, Hospital Universitari Arnau de Vilanova LleidaServicio de Farmacia, Complejo Hospitalario Universitario de Santiago de CompostelaServicio de Farmacia, Hospital Clínico Universitario Lozano BlesaServicio de Farmacia, Hospital General Universitario de ElcheServicio de Farmacia, Hospital Clínic de BarcelonaServicio de Farmacia, Complejo Hospitalario de ToledoServicio de Farmacia, Hospital Universitari Arnau de Vilanova LleidaServicio de Farmacia, Hospital Universitari Arnau de Vilanova LleidaAstraZeneca Farmacéutica SpainAstraZeneca Farmacéutica SpainAbstract Purpose We aimed to evaluate adherence to oral antineoplastic therapy (OAT) in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and its potential relationship with several clinical outcomes. Methods Observational, prospective, multicenter study performed by 6 hospital pharmacists in Spain. The primary outcome was the proportion of treatment adherence as evaluated by pill reconciliation during the 3-month active follow-up period. Those with an adherence > 80% were categorized as adherent. We performed multivariate Cox regression analyses to explore the factors associated with progression-free survival. Results From December 2019 to November 2022, we recruited 95 evaluable patients. Most of the patients received osimertinib (n = 45, 45.3%) or a first- or second-generation tyrosine kinase inhibitor (n = 23, 34.8%). Eighty-one patients showed greater than 80% adherence (85.3%, 95% CI 78.1% to 92.4%), as evaluated based on pill reconciliation; the mean (SD) adherence to OAT was 94.7% (11.4). According to the univariate analysis, the time to progression from study entry was significantly shorter among patients who were nonadherent than among those who were adherent (median 6.5 months vs. not reached, log-rank test p = 0.006; hazard ratio [HR] 2.619, 95% confidence interval [CI] 1.240–5.532). In the multivariate Cox regression analysis, nonadherence was the single factor associated with progression-free survival. Conclusion Consistent with previous evidence in this setting, our results suggest that adherence to oral antineoplastic treatment among patients with NSCLC is high. Whether this high rate of adherence translates to better clinical outcomes should be further evaluated in larger samples.https://doi.org/10.1007/s00432-025-06264-0Non-small cell lung cancerOral chemotherapyTyrosine kinase inhibitorsAnaplastic lymphoma kinase inhibitorsAdherenceProgression-free survival
spellingShingle Irene Mangues-Bafalluy
Beatriz Bernardez
José Manuel Martínez-Sesmero
Andres Navarro-Ruiz
Maria Teresa Martín-Conde
Ana Rosa Rubio-Salvador
Judith Rius-Perera
Marta Gilabert-Sotoca
Marta Domínguez López
Angel Callejo Mellén
Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study
Journal of Cancer Research and Clinical Oncology
Non-small cell lung cancer
Oral chemotherapy
Tyrosine kinase inhibitors
Anaplastic lymphoma kinase inhibitors
Adherence
Progression-free survival
title Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study
title_full Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study
title_fullStr Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study
title_full_unstemmed Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study
title_short Adherence to oral antineoplastic therapy among patients with advanced or metastatic non-small cell lung cancer: a noninterventional, prospective study
title_sort adherence to oral antineoplastic therapy among patients with advanced or metastatic non small cell lung cancer a noninterventional prospective study
topic Non-small cell lung cancer
Oral chemotherapy
Tyrosine kinase inhibitors
Anaplastic lymphoma kinase inhibitors
Adherence
Progression-free survival
url https://doi.org/10.1007/s00432-025-06264-0
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