Advances and Best Practices in the Utilization of Novel Agents in Metastatic Breast Cancer - Episode 17
Kate Jeffers, PharmD: The feedback I’ve gotten from patients so far is that they appreciate being at home. They’re able to work these medications into their daily lives, and they don’t feel like their diagnosis is now taking over their life. Unfortunately, we’ve had some younger patients recently, and so when you think about having a younger patient who has family members at home or children and really just being able to continue living your life or living their life, I think it’s very important to them. The quality of life with these medications is something that when I’m doing education with patients I focus on. We do know that there are adverse effects. We talk about the lab parameter monitoring that we need to do. We talk about how to get the medication, how to take the medication, and ways to help minimize adverse effects so that patients feel empowered while they’re at home to be able to manage side effects and not just feel like they have to call the office for everything.
In terms of continuous dosing, I think this is a benefit for the abemaciclib in that it’s easier for patients to remember to take. Thinking about a 3-week on, 1-week off schedule, plus potentially continuous AI [aromatase inhibitor], you have 2 different things that you have to remember and 2 different things that you have to manage on top of whatever other medications you may or may not be taking at home. So I really focus with patients on the best way, if they are going to be on the 3-on, 1-off schedule, to fit that into their lifestyles.
So, of course, we want patients to start medication as soon as they receive it, but I tell patients if remembering to start and stop on a Tuesday is not going to work for you then let’s wait until Saturday, or let’s wait until Sunday or Monday, or whatever is going to work best for your lifestyle, that we’re able to keep you on therapy and have you remember to take the drug, which is the most important thing. It’s the same thing with a morning versus an evening schedule, really focusing on what’s going to be the easiest for the patient. And so I spend a lot of time in my education sessions talking through with patients how to fit these medications into their lifestyles. The continuous dosing is a little bit easier because it’s just taken every day versus trying to work through with patients when they’re going to get their medication and how they’re going to remember to take it.
The other issue that we run into with all of these medications though is delays from a specialty pharmacy. So, if it’s a 3-week on, 1-week off, or continuous, if they don’t have the drug they can’t take the drug. And so, we are really making sure patients understand that they have to call in with a certain amount of time for refills. They have to give that lead time in working with either the specialty pharmacy or in-house pharmacy, whatever it may be, to really be able to have patients get their medication and be able to take it.