We all recognise that cancer is a complex disease with multiple nuances in indications and impacts. And while we have come a long way in developing therapies to combat or manage cancers, there has remained for some time now, real concerns about the lack of medication adherence. Most of the reasons for poor adherence are attributed to the adverse effects of the toxicity of the medication – as we have reported before the perceived wisdom being that the compromise between high efficacy and high toxicity can be justified. Of course, we continue to argue that with effective adherence monitoring at the clinical trial stage, we can establish an optimum dose that mitigates the negative effects of higher than necessary levels of toxicity.
Whichever source of information you lean on, you know that cancer is the second leading cause of death globally, after cardiovascular disease having accounted for more than 10 million deaths in 2020. And this prevalence is set to continue as it is expected that there will be 22 million cases of cancer every year over the course of the next 20 years.
A recent review published in January 2024 titled ‘Medication Adherence in Cancer Patients: A Comprehensive Review’[1] discusses the many and varied aspects of cancer medication adherence, reflecting that poor therapeutic adherence is a significant issue among patients and that the few studies that attempted to understand the factors for nonadherence have been plagued with bias.
This, we believe is where AARDEX demonstrates clear benefits at the clinical trial stages delivering clarity, integrity and certainty around the optimum dose required to bring confidence to sponsors, trialists, and ultimately, patients.???
As part of our work, we collaborate with over 500 research centers and academic institutions to deepen the understanding of medication adherence across a diverse range of therapeutic areas. Notably, since 2021, an average of one paper per quarter has been published using MEMS technology to study medication adherence in oncology. This steadily growing body of literature underscores the persistent challenge of non-adherence, even in life-threatening conditions like cancer.
- Rosentreter J, Alt J, Fried M, Chakupurakal G, Stratmann J, Kr?mer I. Multi-center observational study on the adherence, quality of life, and adverse events in lung cancer patients treated with tyrosine kinase inhibitors. J Oncol Pharm Pract. 2021 Jul;27(5):1147-1158. doi: 10.1177/1078155220946381. Epub 2020 Aug 3. PMID: 32746691.
- Jacobs JM, Rapoport CS, Horenstein A, Clay M, Walsh EA, Peppercorn J, Temel JS, Greer JA. Study protocol for a randomised controlled feasibility trial of a virtual intervention (STRIDE) for symptom management, distress and adherence to adjuvant endocrine therapy after breast cancer.?BMJ Open.?2021 Jan 4;11(1):e041626.?doi: 10.1136/bmjopen-2020-041626. PMID: 33397667; PMCID: PMC7783524.
- Jacobs JM, Post K, Massad K, Horick NK, Walsh EA, Cohn J, Rapoport CS, Clara A J, Antoni MH, Safren SA, Partridge AH, Peppercorn JM, Park ER, Temel JS, Greer JA. A telehealth intervention for symptom management, distress, and adherence to adjuvant endocrine therapy: A randomized controlled trial. Cancer. 2022 Oct 1;128(19):3541-3551. doi: 10.1002/cncr.34409. Epub 2022 Aug 4. PMID:?35924869; PMCID: PMC9465981.
- Lasala R, Santoleri F, Romagnoli A, Abrate P, Musicco F, Costantini A. Medication adherence reporting in pivotal clinical trials: overview of oral oncological drugs. Eur J Hosp Pharm.?2023 Nov;30(6):328-332. doi: 10.1136/ejhpharm-2021-002998.?Epub 2022 Jan 20. PMID:?35058307; PMCID: PMC10647863.
- Bandiera C, Locatelli I, Courlet P, Cardoso E, Zaman K, Stravodimou A, Dolcan A, Sarivalasis A, Zurcher JP, Aedo-Lopez V, Dotta-Celio J, Peters S, Guidi M, Wagner AD, Csajka C, Schneider MP. Adherence to the CDK 4/6 Inhibitor Palbociclib and Omission of Dose Management Supported by Pharmacometric Modelling as Part of the OpTAT Study. Cancers (Basel).?2023 Jan 3;15(1):316. doi: 10.3390/cancers15010316. PMID:?36612312; PMCID: PMC9818079.
- McCune JS, Armenian SH, Nakamura R, Shan H, Kanakry CG, Mielcarek M, Gao W, Mager DE. Immunosuppressant adherence in adult outpatient hematopoietic cell transplant recipients. J Oncol Pharm Pract. 2024 Mar;30(2):322-331. doi: 10.1177/10781552231171607. Epub 2023 May 3. PMID: 37134196; PMCID: PMC10622331.
- Ralph JE, Sezgin E, Stanek CJ, Landier W, Pai ALH, Gerhardt CA, Skeens MA. Improving medication adherence monitoring and clinical outcomes through mHealth: A randomized controlled trial protocol in pediatric stem cell transplant. PLoS One. 2023 Aug 17;18(8):e0289987. doi: 10.1371/journal.pone.0289987. PMID: 37590237; PMCID: PMC10434937.
- Wheeler SB, Spencer J, Drier SW, Fray N, Reeder-Hayes KE. Motivational Interviewing Counseling to Increase Endocrine Therapy Adherence in Diverse Patients. Cancers (Basel). 2023 Mar 25;15(7):1973. doi: 10.3390/cancers15071973. PMID: 37046634; PMCID: PMC10093612.
- Bandiera C, Cardoso E, Locatelli I, Zaman K, Diciolla A, Digklia A, Stravodimou A, Cristina V, Aedo-Lopez V, Dolcan A, Sarivalasis A, Bouchaab H, Pasquier J, Dotta-Celio J, Peters S, Wagner D, Csajka C, Schneider MP. A pharmacist-led interprofessional medication adherence program improved adherence to oral anticancer therapies: The OpTAT randomized controlled trial. PLoS One. 2024 Jun 7;19(6):e0304573. doi: 10.1371/journal.pone.0304573. PMID: 38848380; PMCID: PMC11161104.
- Haider I, Pond GR, Cameron R, Aljama M, Kouroukis TC, Wong K, Fiala MA, Wildes TM, Mian H. A structured oral chemotherapy teaching tool to improve adherence in adults with multiple myeloma: A pilot randomized controlled trial. J Geriatr Oncol. 2024 Apr;15(3):101735. doi: 10.1016/j.jgo.2024.101735. Epub 2024 Mar 8. PMID: 38460399.
- Willis KD, Walsh EA, Dunderdale LE, Post K, Horick N, Antoni MH, Safren SA, Partridge AH, Peppercorn J, Park ER, Temel JS, Greer JA, Jacobs JM. Effects of Adjuvant Endocrine Therapy-Specific Perceptions on Response to a Behavioral Intervention for Adjuvant Endocrine Therapy Adherence in Patients With Breast Cancer. JCO Oncol Pract. 2024 Aug 13:OP2400316. doi: 10.1200/OP.24.00316. Epub ahead of print. PMID: 39137385.
