Perception Is Patients

From 2004 to 2013, 22 new oral anticancer medications were introduced in the United States, which is almost the same number (27) of oral anticancer medications that were introduced in the previous 50 years combined.¹ Of the US Food and Drug Administration (FDA)-approved myeloma novel therapies, 5 are orally administered.² With the FDA approval of ixazomib (Ninlaro; a first-in-class oral proteasome inhibitor) in November 2015, an all-oral treatment combination for patients with myeloma is now a reality with the combination of ixazomib, lenalidomide (Revlimid), and dexamethasone (Decadron).³

With the improved diagnosis and availability of treatment and care, some patients with myeloma are living longer; median survival for younger standard-risk patients is approaching >10 years.⁴ Oral myeloma drugs play a big part in continuing this trend, not only because they are preferred by patients, but also because there are more of them in the drug pipeline.⁵

Oral anticancer medications are preferred by most patients because of their ease of administration (ie, no searching for a vein, no starting an IV, no bruising from subcutaneous injection), and may even increase medication adherence, because patients can take them while traveling, during the holidays, or when their physician is not available. Taking medication orally also prevents time being wasted in the clinic waiting room, and can allow patients to gain back some of the level of control and empowerment they lost when they were diagnosed with cancer.⁵

Unfortunately, preference does not always result in adherence to the medication schedule. In addition to the operational complexity of acquiring anticancer oral medications, medication cost, treatment side effects, disease progression, complexity of instructions, and simply forgetting are some of the reasons patients with cancer do not take their medication as prescribed. For these reasons, patients can take medication at a lower dose than prescribed, less often than prescribed, or, in some cases, more than prescribed.⁵

There are telltale signs that indicate patients may not be taking their medications as prescribed, including a less frequent prescription refill rate, progressing disease, and not having the expected side effects