Patient and physician perspective on published therapy management recommendations for TKI-treated patients with a focus on sunitinib: The TheMaPaC project (Therapy Management Patient Consensus).

Abstract

445 Background: Optimizing outcomes in RCC or GIST patients (pts) receiving TKI (e.g. sunitinib ([U]) involves therapy management as a key component. Reduction/elimination of adverse events (AEs) by prevention/early intervention may improve quality of life and enable adequate duration of therapy. Published recommendations (RECs) for AE management are heterogeneous and often rely on hypothetical considerations or limited evidence. A collaborative effort of physicians, patients, and Pfizer addresses these issues. An initial analysis of a patient survey on real-life validity of RECs in 27 TKI-treated pts was shown at ASCO 2012 (abstr. 99588). We report an updated combined analysis with an expert survey in 23 physicians experienced in SU use for RCC and GIST. Methods: RECs for AE management in pts receiving SU or other VEGFR-TKIs were retrieved from the literature since 2006 and listed in a questionnaire (QU). For the patient survey, RECs were converted into patient-friendly language, RECs requiring physician intervention/decision were excluded. Pts rated RECs in 5 categories (positive/negative experience [self/others]; no information). Experts rated the RECs according to strength of their consent and own experiences. Results: 27 pts had evaluable QUs. Pts were on SU for 16 months (median). On average, 49% of RECs were rated positive; 44% based on individual experience. 20 RECs were rated positively by >80% of pts. Pts had most positive experiences with RECs concerning pt/physician communication on AEs, care/protection of feet and skin, food preference, hydration, and fatigue. Pts had a preference for RECs with low interference in daily life. RECs rated positive by >80% of pts were supported by most experts. Several RECs supported by most experts were unknown to many pts, including dermatological interventions, dietary counselling, and self-perception. Conclusions: To our knowledge, this is the first patient and expert survey on validity and practicability of published AE management RECs. The data identify useful consensual RECs from real-life perspective. TKI therapy management may be improved by enhanced pt education.