P-0225 Adherence Of Capecitabine in Colorectal or Metastatic Breast Cancer

Abstract

ABSTRACT Introduction The increasing availability of oral drugs for oncology treatment led to studies about adherence. Low adherence can impact the successful of the treatment. Nurses and pharmaceutics can play a significant role monitoring and identifying barriers and implementing strategies to increase adherence. Capecitabine (a pro-fluoropyrimidine) is an oral drug mostly used in gastro-intestinal and breast cancer. The efficiency of capecitabine is similar of the 5FU and is most convenient to the patient. Aim: to investigate the adherence of the treatment with oral capecitabine for metastatic breast cancer (MBC) and colorectal cancer on adjuvant or palliative treatment. Correlate the adherence of the drug to possible changes in patient's quality of life. Methods This prospective cohort study included patients with metastatic colorectal cancer (MCRC) or non-metastatic colorectal cancer (CRC) and patients with MBC using capecitabine alone or in association with other drugs or radiotherapy (RT). The patients were treated with a 3-weekly regimen of capecitabine 1000 bid mg/m2 for 14 days. The pills were given by the pharmaceutics after a short explanation. Two methods had been done to evaluate adherence before each cycle for 4 cycles: a self-report short questionnaire about the intake of the drugs diary and a manual count of unused medication before the delivery of the next cycle pills. The quality of life questionnaire QLQ-C30 (EORTC) was applied at the first visit before beginning the treatment and after 4 cycles. Results 30 patients had been included, being 6 with MBC, 9 MCRC and 16 CRC. The mean age was 60 years old and 20 were females. Three patients received capecitabine on monotherapy, 18 capecitabine associated to other chemotherapies and 9 capecitabine associated to radiotherapy. After 4 cycles the adherence was 88.3% for metastatic colon cancer, 90.4% for non-metastatic colon cancer, 94.3% for rectal cancer and 96.2% for metastatic breast cancer. No difference was found between adherence and localization of the tumor (p=0.606) or between the capecitabine on monotherapy or in association with others drugs or RT (p=0.105). The high adherence had been probably influenced by the pharmaceutical explanation although a control group without this interview was not done. Dyspnea at the beginning of the treatment had been correlated to a less adherence of the drug during the period studied (r= -0.37, p=0.042). No correlation between adherence and EORTC QLQ-C30 functional or symptom scale rates was found at the last evaluation. Conclusion Although no absolute adherence to oral capecitabine treatment was observed, the level of adherence was considered good. A negative correlation between adherence and dyspnea was found.