title: Anticancer oral therapy: emerging related issues.
abstract: The use of oral anticancer drugs has shown a steady increase. Most patients prefer anticancer oral therapy to intravenous treatment primarily for the convenience of a home-based therapy, although they require that the efficacy of oral therapy must be equivalent and toxicity not superior than those expected with the intravenous treatment. A better patient compliance, drug tolerability, convenience and possible better efficacy for oral therapy as compared to intravenous emerge as the major reasons to use oral anticancer agents among oncologists. Inter- and intra-individual pharmacokinetic variations in the bioavailability of oral anticancer drugs may be more relevant than for intravenous agents. Compliance is particularly important for oral therapy because it determines the dose-intensity of the treatment and ultimately treatment efficacy and toxicity. Patient stands as the most important determinant of compliance. Possible measures for an active and safe administration of oral therapy include a careful preliminary medical evaluation and selection of patients based on possible barriers to an adequate compliance, pharmacologic issues, patient-focused education, an improvement of the accessibility to healthcare service, as well as the development of home-care nursing symptom-focused interventions. Current evidences show similar quality of life profile between oral and intravenous treatments, although anticancer oral therapy seems to be more convenient in terms of administration and reduced time lost for work or other activities. Regarding cost-effectiveness, current evidences are in favor of oral therapy, mainly due to reduced need of visits and/or day in hospital for the administration of the drug and/or the management of adverse events.
authors.affiliation: Division of Medical Oncology, Vittorio Emanuele University Hospital, Via Plebiscito, 628, 95124 Catania, Italy. gbanna@yahoo.com
authors.forename: Giuseppe Luigi
authors.initials: GL
authors.lastname: Banna
authors.forename: Elena
authors.initials: E
authors.lastname: Collovà
authors.forename: Vittorio
authors.initials: V
authors.lastname: Gebbia
authors.forename: Helga
authors.initials: H
authors.lastname: Lipari
authors.forename: Pietro
authors.initials: P
authors.lastname: Giuffrida
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cavallaro
authors.forename: Rosaria
authors.initials: R
authors.lastname: Condorelli
authors.forename: Calogero
authors.initials: C
authors.lastname: Buscarino
authors.forename: Paolo
authors.initials: P
authors.lastname: Tralongo
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferraù
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics* / Q000494:pharmacology; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004347:Drug Interactions; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010349:Patient Compliance; D017060:Patient Satisfaction; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents