Several oral agents have been proven active in the treatment of certain subtypes of non-Hodgkin lymphomas, including chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), follicular lymphoma (FL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL) and Waldentröm macroglobulinemia (WM); and for chronic graft versus host disease (cGVHD).
While efficacy and patient preference for oral agents have been reported, there is a lack of knowledge about its use in clinical practice, particularly regarding the effects of medication adherence.
A recent study published in Leukemia & Lymphoma constructed a conceptual model and highlighted key opportunities for future research to address the challenges lymphoma patients face regarding oral therapy adherence.
To identify knowledge gaps in oral therapy adherence, the study authors—including Lymphoma Research Foundation Scientific Advisory Board members Christopher Flowers, MD, MS (Winship Cancer Institute, Emory University) and Jonathan Friedberg, MD, MMSc (Wilmot Cancer Institute, University of Rochester); and Mary Somma (Scientific and Research Programs, Lymphoma Research Foundation)—conducted a thorough search of PubMed and Medline electronic databases for studies regarding oral treatments for cancer and adherence to or compliance with therapy.
It was found that the rising cost of treatment and health insurance, the frequency and complexity of prescribed daily dosage, and interactions between other oral therapies and common medications contribute to poorer adherence.
In addition, the ways in which adherence is measured remain a major issue. There is no universal method in measuring adherence rates. This also creates a serious barrier to research and understanding of overall adherence for patients with lymphoma.
Suggested Conceptual Model and Research Opportunities
Based on their research, the authors constructed a conceptual model that identified areas of interest that require investigation and highlighted opportunities for research to better understand oral therapy adherence in lymphoma patients.
These interests range from general approaches such as determining the pattern of nonadherence in lymphoma and whether it differs from other cancers, to more specific topics, such as particular challenge for lymphoma patients based on the side effects of lymphoma-specific treatments that may inhibit proper adherence.
Other areas included in the conceptual model is the impact of patient education and understanding of healthcare information, which according to the authors, could improve not only adherence to treatment, but other areas of healthcare.
Research used to inform this study includes the Lymphoma Research Foundation’s white papers Oral Therapies in Lymphoma: Opportunities and Challenges in Research and Treatment and Oral Therapies in Lymphoma and CLL.
Other authors of this study include Drs. Alix Y.L. Zackon (Winship Cancer Institute, Emory University); Amy A. Ayers (Winship Cancer Institute, Emory Univeristy); Katherine A. Yeager (Winship Cancer Institute, Emory University); and Loretta J. Nastoupil (MD Anderson Cancer Center).
LRF Adherence in Oral Therapies Scientific Meeting Featured in ASCO Post
Scientific proceedings and priorities from LRF’s Adherence in Oral Therapies Scientific Meeting has been published in the scientific journal, The ASCO Post. Read more >