title: Italian multicenter survey to evaluate the opinion of patients and their reference clinicians on the "tolerance" to targeted therapies already available for non-small cell lung cancer treatment in daily clinical practice.
abstract: BACKGROUND
  The introduction of targeted therapies in non-small cell lung cancer (NSCLC) treatment has led to emerging toxicities, whose management and impact on quality-of-life (QoL) is not clearly defined. Aim of this Italian multicenter survey was to highlight any discrepancy between patients' and clinicians' perception of such toxicities in order to improve their management.
  
  
  METHODS
  From October 2013 to April 2014, 133 NSCLC advanced patients, treated with targeted therapies, were consecutively enrolled to assess toxicities and QoL with dedicated questionnaires. One hundred and sixteen patients were included in the final analysis, having attended three consecutive evaluations (T0, T1, T2), starting at least 15 days after the biological treatment. The survey required monthly compilation of both physicians and patients' questionnaires, basing adverse event evaluation on CTCAE version 4.0.
  
  
  RESULTS
  Most of the patients received either an EGFR-TKI or an anaplastic lymphoma kinase (ALK) inhibitor as targeted therapy (84.5% and 13.8%, respectively). At every checkpoint (T0, T1, T2) a significant difference in terms of perception of targeted therapies-related toxicities of any type and grade was described (P value =0.0001 in all cases). This difference was more pronounced for skin toxicity, fatigue and diarrhea. Furthermore, also the assessment of QoL revealed contrasting data between patients and clinicians, mainly QoL reported as good by the majority of patients and daily activities considered as slightly influenced by targeted therapies.
  
  
  CONCLUSIONS
  In our knowledge, this is the first prospective survey in patients and doctors specifically designed for targeted therapies in advanced NSCLC. The results show an underestimation of toxicities by clinicians when compared with patients, the difference being greater for adverse events more strongly associated with daily life and QoL. Further studies are needed to confirm our first results. The discrepancy in perception of targeted therapies-related toxicities should be a result from which to start thinking about a new approach in their management.
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Silvia
authors: S
authors: Novello
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Enrica
authors: E
authors: Capelletto
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Diego
authors: D
authors: Cortinovis
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Marcello
authors: M
authors: Tiseo
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Domenico
authors: D
authors: Galetta
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Giuseppe
authors: G
authors: Valmadre
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Clelia
authors: C
authors: Casartelli
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Simonetta Grazia
authors: SG
authors: Rapetti
authors: 1 Oncology Department, University of Turin, AOU San Luigi Orbassano, Italy ; 2 Medical Oncology, San Gerardo Hospital, Monza, Italy ; 3 Medical Oncology Unit, University Hospital of Parma, Parma, Italy ; 4 U.O. Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy ; 5 Medical Oncology, Presidio Ospedaliero E.Morelli AOVV, Sondalo (So); 6 Oncology Unit, Valduce Hospital, Como, Italy ; 7 Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
authors: Antonio
authors: A
authors: Rossi
keywords: Adverse effects; non-small cell lung cancer (NSCLC); patients’ reports; targeted therapy