Current practices in the management of adverse events associated with targeted therapies for advanced renal cell carcinoma: A national survey of oncologists Journal Article


Authors: Ruiz, J. N.; Belum, V. R.; Creel, P.; Cohn, A.; Ewer, M.; Lacouture, M. E.
Article Title: Current practices in the management of adverse events associated with targeted therapies for advanced renal cell carcinoma: A national survey of oncologists
Abstract: Current practices and attitudes of oncologists in the management of adverse events (AEs) from targeted therapies in renal cell carcinoma (RCC) patients are poorly understood. To address this issue, we analyzed survey responses of 101 oncologists. Results suggest that many patients with RCC require dose modifications/ discontinuation because of targeted therapyerelated AEs and that nononcologists are frequently consulted to manage these events. Background: Oncologists treating patients with targeted therapies encounter adverse events (AEs) that pose management challenges, lead to dosing inconsistencies, and impact patient quality of life. Oncologists' practices and attitudes in the management of targeted therapyerelated AEs in patients with renal cell carcinoma (RCC) are poorly understood. We sought to identify unmet needs associated with AE management and understand oncologists' treatment optimization strategies. Methods: A 24-item online survey was administered in August 2012 to 119 US oncologists treating patients with advanced RCC. The survey solicited responses regarding demographics, practice settings, AE management practice patterns and beliefs, treatment barriers, and patient education. Results: Respondents indicated that between 25% and 50% of patients require dose modification/discontinuation because of AEs. The greatest barrier to optimizing treatment for RCC is the unpredictability of patient responses to treatment (43%). Most respondents (78%) discuss AE management with patients, but only a minority of them proactively reach out to patients (46%). Most practitioners (70%) refer patients to nononcology specialists when faced with unfamiliar AEs, although finding interested physicians (43%) and time constraints (40%) were the most commonly cited barriers to consulting with other specialties. Conclusion: Results suggest that many patients require dose modification/ discontinuation because of AEs and that nononcologists are a frequently utilized resource to manage these events. There is a need for predictive drug toxicity markers to establish counseling and prevention, along with opportunities for increased education on supportive care techniques to maintain health-related quality of life and consistent dosing.
Keywords: major clinical study; fatigue; advanced cancer; hypertension; antineoplastic agent; patient education; kidney carcinoma; therapy delay; patient safety; physician; adverse drug reaction; patient referral; molecularly targeted therapy; anticancer therapy; human; article; advanced kidney cancer; side effect management practices; oncologist practice patterns; targeted therapyerelated side effects
Journal Title: Clinical Genitourinary Cancer
Volume: 12
Issue: 5
ISSN: 1558-7673
Publisher: Elsevier Inc.  
Date Published: 2014-10-01
Start Page: 341
End Page: 347
Language: English
DOI: 10.1016/j.clgc.2014.04.001
PROVIDER: scopus
PMCID: PMC4181324
PUBMED: 25035283
DOI/URL:
Notes: Export Date: 2 March 2015 -- Source: Scopus
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  1. Mario E Lacouture
    457 Lacouture
  2. Viswanath Reddy Belum
    38 Belum
  3. Janelle Nicole Ruiz
    2 Ruiz