Adverse events of targeted therapies reported by patients with cancer treated in primary care

Abstract

Background Targeted Therapies (TT) are among the therapeutic innovations for cancer treatment in outpatient settings. TT-related Adverse Events (AEs) are a source of loss of opportunity for patients if their management is inappropriate. Objectives The objective of this study was to describe the AE frequency and severity as reported by patients with cancer who received TT in ambulatory settings. A second objective was to describe the role of the general practitioner (GP) in the management of AEs. Methods All patients who started TT at a French Regional Cancer Centre in 2017–2018 were eligible for this 12-month prospective study. A self-administered questionnaire was distributed at inclusion and returned after three months. In the questionnaire, patients listed all AEs that occurred during this period and rated their severity. Occurrence and severity were compared with the rating by a specialised nurse. Patients also indicated the health professional they contacted first for the reported AE. Results Among the 247 eligible patients, 15 were excluded and 144 responded to the questionnaire. Fourteen different TTs have been prescribed. Asthenia (92.4%) and anorexia (64.6%) were the most frequent AE. Patients’ AE severity rating was more severe than the nurse’s rating for all drugs (p < 0.001). Patients first contacted their GP for 15.6% of AEs, whereas 20.7% of AEs were not reported to any health professional. Conclusion Patients experienced an average of 4 AEs. AE severity rating was significantly different between patients and nurses. Patients do not always communicate AEs to health care professionals.