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Factors Associated With Regorafenib Adherence With Metastatic Colorectal Cancer

Authors Kawakami K, Wakatsuki T, Soejima A, Kobayashi K, Yokokawa T, Aoyama T, Suzuki K, Suenaga M, Yamaguchi K, Inoue A, Machida Y, Hama T

Received 2 June 2019

Accepted for publication 21 September 2019

Published 15 October 2019 Volume 2019:13 Pages 1745—1750


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Kazuyoshi Kawakami,1 Takeru Wakatsuki,2 Azusa Soejima,1 Kazuo Kobayashi,1 Takashi Yokokawa,1 Takeshi Aoyama,1 Kenichi Suzuki,1 Mitsukuni Suenaga,2 Kensei Yamaguchi,2 Ayaka Inoue,3 Yoshiaki Machida,3 Toshihiro Hama1

1Department of Pharmacy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-Ku, Tokyo 135-8550, Japan; 2Department of Gastroenterological Chemotherapy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-Ku, Tokyo 135-8550, Japan; 3Section for Practical Education, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Shinagawa-Ku, Tokyo 142-8501, Japan

Correspondence: Kazuyoshi Kawakami
The Japanese Foundation for Cancer Research, Cancer Institute Hospital, Depatment of Pharmacy, 3-8-31 Ariake Koto-ku, Tokyo 135-8550, Japan

Introduction: Regorafenib is an oral multikinase inhibitor for the treatment of metastatic colorectal cancer (mCRC). The clinical factors that may affect adherence to regorafenib remain unclear. The aim of this study was to evaluate adherence to regorafenib with mCRC and to identify factors that might affect adherence to regorafenib.
Methods: A total of 108 consecutively enrolled Japanese patients with mCRC received regorafenib. Adherence was measured by pharmacists using pill counts and a self-reported treatment diary for patients at a pharmaceutical outpatient clinic. The median relative dose intensities of regorafenib and the factors adversely affecting adherence were retrospectively surveyed. Logistic regression analysis was then performed using patient socio-demographic factors and clinical factors.
Results: A total of 96 patients were included in the analysis. The median adherence rate was 61.7% in the first cycle. The median relative dose intensity was 57.1%. The most common reason for non-adherence was a hand-foot-skin reaction (35.6%). On multivariate analysis, increased non-adherence to regorafenib was significantly associated with sex (female) [odds ratio (OR) = 4.36; 95% confidence interval (CI): 1.43–13.22, p = 0.01].
Discussion: Hand-foot-skin reactions and female sex were associated with lower adherence to regorafenib. Since these factors could be associated with lower adherence to regorafenib, it would be useful to consider these factors when assessing adherence.

Keywords: adherence, regorafenib, colorectal cancer, hand-foot-skin reactions

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