title: Treatment monitoring program for implementation of adherence to second-line erlotinib for advanced non-small-cell lung cancer.
abstract: BACKGROUND
  Adherence to erlotinib could be a determinant for clinical outcome and treatment toxicity in patients with advanced non-small-cell lung cancer (A-NSCLC).
  
  
  METHODS
  In an observational study, the Basel Assessment of Adherence Scale (BAAS), a visual analogue scale (VAS), pill counting, and missed appointment rate were used to evaluate adherence in a first cohort of patients who was prescribed erlotinib without a specifically designed management strategy and in a second cohort of patients followed by an oral treatment monitoring program.
  
  
  RESULTS
  Adherence > 95% by BAAS at 2 months of treatment in the first and second cohorts was 72% and 84%, respectively (P = .042). Adherence by pill counting was 78% and 87% in the first and second cohorts, respectively (P = .0021). Disease control rate (DCR) (complete response [CR] + partial response [PR] + stable disease [SD]) was significantly higher in all patients whose adherence by BAAS at 2 months was ≥ 95% (P = .0266). DCR was higher in the second cohort compared with the first, being 63% (95% confidence interval [CI], 53%-72%) and 44% (95% CI, 30%-58%) in the second and the first cohort, respectively (P = .0368). A significant correlation between the number of adverse events and patient-reported adherence was observed (r = 0.105; P = .0001).
  
  
  CONCLUSIONS
  Nonadherence may be related to poorer rates of response to erlotinib. Effective interventions to reduce nonadherence need to be implemented.
authors: Medical Oncology Unit, La Maddalena Clinic for Cancer, University of Palermo, Palermo, Italy.
authors: Vittorio
authors: V
authors: Gebbia
authors: Massimo
authors: M
authors: Bellavia
authors: Giuseppe Luigi
authors: GL
authors: Banna
authors: Paolo
authors: P
authors: Russo
authors: Francesco
authors: F
authors: Ferraù
authors: Paolo
authors: P
authors: Tralongo
authors: Nicolò
authors: N
authors: Borsellino
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D016903:Drug Monitoring; D000069347:Erlotinib Hydrochloride; D005260:Female; D005500:Follow-Up Studies; D006284:Health Plan Implementation; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use*; D012189:Retrospective Studies; D016879:Salvage Therapy; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride