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H. Drexler

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-058 - Impact of Low-Grade Toxicity on Lung Cancer Patient Willingness to Undergo Treatment with Novel Agents (ID 2147)

      09:30 - 17:00  |  Author(s): H. Drexler

      • Abstract
      • Slides

      Targeted therapies have shown clinical benefit in the treatment of solid tumors. The route, frequency, and duration of administration of these agents as well as toxicity profiles differ significantly from traditional cytotoxic chemotherapy. Many studies of targeted therapies report significant numbers of grade 1 or 2 toxicities, which are often regarded as clinically insignificant. We sought to explore whether anticipation of low-grade toxicities and dosing convenience would affect lung cancer patient willingness to undergo therapy.

      101 lung cancer patients were surveyed at the Vanderbilt Ingram Cancer Center regarding willingness to comply with treatment based on anticipated efficacy, dosing convenience, and toxicity profiles. All toxicities described were CTCAE V.4.0 grade 1 and 2. Willingness to comply with treatment depending upon toxicity, anticipated benefit, and dosing convenience were compared.

      A substantial number of patients professed unwillingness to undergo treatment due to anticipation of chronic grade 1 and 2 toxicities (Table 1). Gastrointestinal (anorexia, nausea, vomiting, diarrhea, or dysgeusia) and constitutional toxicity (fatigue) had a stronger negative impact on patient willingness to undergo therapy than dermatologic toxicity (rash, hand-foot syndrome, or acne). Willingness to tolerate toxicities correlated with expected benefit in life expectancy and chance of cure. Lengthy travel distance for treatment also negatively impacted willingness to undergo treatment.

      Table 1: Percentage of lung cancer patients who stated that they would be unwilling to receive treatment by toxicity type and grade.
      Adverse Effect Unwilling to Receive Treatment
      Grade 1 Dermatologic Toxicity 5.2%
      Grade 1 Gastrointestinal Toxicity 9.5%
      Grade 1 Constitutional Toxicity 6.8%
      Grade 2 Dermatologic Toxicity 8.7%
      Grade 2 Gastrointestinal Toxicity 18.1%
      Grade 2 Constitutional Toxicity 19.4%

      Anticipation of chronic low grade toxicities and dosing inconvenience has a negative impact on patient willingness to be treated, which may affect patient adherence and outcomes from therapy. Long-term tolerability should be considered when developing and using novel agents in lung cancer patients.

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