Oral targeted therapies: managing drug interactions, enhancing adherence and optimizing medication safety in lymphoma patients

Abstract

The advent of newer, targeted oral chemotherapy medications such as small molecule kinase inhibitors, ibrutinib and idelalisib, has created additional options for the treatment of lymphoma. The targeted nature of these agents offers many patient-identified advantages over older, intravenously administered chemotherapy regimens such as ease of self-administration and an increased sense of independence. However, newer oral agents also present unique challenges not previously experienced with older therapies that may affect safety, efficacy and patient adherence. In this article, we review oral agents for the treatment of lymphoma, how to evaluate and manage drug–drug and drug–food interactions with concomitant oral medications, and issues with patient adherence as well as methods to determine adherence for oral chemotherapy.

Keywords:

• drug adherence
• drug–drug interactions
• drug–food interactions
• lymphoma
• oral chemotherapy
• targeted therapy

Financial & competing interests disclosure

S Liewer has provided consulting work for Amgen, Seattle Genetics and Bristol-Meyer-Squibb. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• New targeted therapies are becoming more prevalent in the treatment of lymphoma.

• Newly approved oral chemotherapy agents typically have limited data regarding drug–drug and drug–food interactions.

• Chronic administration of oral targeted therapies will require a thorough drug–drug and drug–food interactions screening by a health care professional.

• Patient adherence to targeted oral medications is vital to ensure the patient receives the full potential of the therapy.

• There are many barriers that affect the ability of patients to take their medications as prescribed.

• Screening tools are available to practitioners to assist in the assessment of patient adherence to medications.

• Patients administering oral chemotherapy at home present new medication safety challenges for families and health care providers.

Notes