Abstract
ABSTRACT Introduction Sunitinib (SUN) is one of the standard treatment options for metastatic renal cell cancer (mRCC). There are several possible reasons for non-compliance to the prescribed doses: oral intake of the drug, side effects and the existence of multiple dosage forms. Prescribers are not always aware of this non-compliance. Methods In Belgium SUN can only be delivered by the hospital pharmacy. This allows calculation of the used versus the prescribed dose. Based on these data, the minimum number of non-compliant weeks per patient were calculated. Results 34 incident patients were considered, treated in the Ghent University Hospital between 2007–2012. The total number of treatment weeks for this patient group was 1079 (ranging between 1 and 108 weeks). A total of 850 weeks were suitable for analysis. 14 out of these 34 patients (41.2%) had at least one week in their treatment period of non-compliance (insufficient number of pills), with the percentage of time of treatment non-compliance in these individual patients ranging from 2–40 % of the total treatment time, the average being 19 % of the weeks. The group with one or more weeks of non-compliance were the patients with the longest SUN intake: 47.2 versus 20.8 months of intake. On the other hand 5/34 patients (14.7%) received considerably more pills from the pharmacy than their treatment regimen warranted. Conclusions In our single-center database of patients treated by SUN for mRCC, we demonstrated that over 40% of the patients were possibly non-compliant with their prescribed SUN dose. This occurred more frequently in long-term treatment. Given the average non-compliance time in this subgroup (19% of the weeks) we can conclude that this might significantly influence overall survival and response to treatment. We thus advocate a tighter patient follow-up and a control of drug prescription and delivery, which could result in detection of non-compliance more rapidly. Disclosure S. Rottey: Advisory board Pfizer, Novartis, Bayer, GSK Research grant Pfizer, Bayer. All other authors have declared no conflicts of interest.
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