Adherence to Oral Therapies for Cancer: Barriers and Models for Change

O ral chemotherapy and hormonal therapies have been available for decades and include many familiar agents such as cyclophosphamide, melphalan, and tamoxifen. The past decade has witnessed an expansion of oral anticancer drugs, including cytotoxic agents, small-molecule inhibitors, and agents targeted at receptors that regulate cellular differentiation, growth, and survival. Since 2000, more than 40 new anticancer agents and cancer-related supportive care drugs have been approved for use by the U.S. Food and Drug Administration (FDA, 2010). An estimated 25% of anticancer agents in the research pipeline are designated for oral administration (Michaud & Choi, 2008). The infrastructure of chemotherapy administration is changing from episodic intravenous (IV) infusions to continuous oral daily dosing. Many inhibitor therapies are cytostatic and are most effective when given daily over proFrom MCG Oncology, Chicago, IL.