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NCCN task force findings raise questions on future oral chemotherapy use

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HOLLYWOOD, Fla. – Questions of patient adherence and financial considerations, as well as issues of safety, practice and pharmacology were among the concerns found by a recent National Comprehensive Cancer Network task force report on oral chemotherapy, according to Ronald S. Walters, MD, MBH.

Walters, medical director of clinical operations at the University of Texas M.D. Anderson Cancer Center, presented the task force results yesterday at the NCCN 13th Annual Conference.

“As the number of agents increase in the targeted therapy world, we are going to have to wrestle with all the other issues, [such as patients’ adherence, financial considerations and agent distribution], but also when do we stop administering therapy? How do you monitor the right time to stop? When is the patient really normal? I do not know if current technology can handle that yet,” Walters said during his March 6 presentation.

He added that the number of chemotherapy agents administered and the duration are important considerations, which relate to remission and how long it lasts, as well as when to decide to discontinue a patient’s therapy.

In certain instances, Walters said physicians may try various techniques to block a center cancer site, but the cancer seems to bypass the block and impact another area. When the physician attempts to block the center cancer again, it may repeat and bypass the new block. “Pretty soon you find yourself designing a cocktail, as we call it, which starts to impact four or five different checkpoints,” Walters said.

“I think we are going to see patients on chemotherapy cocktails. Many of these targeted agents, of which many will be oral, will increase over the next 10 years. The way we treat cancer 10 years from now is not going to look at all like how we do it today.” – by Paul Burress

For more information:

• Walters RS. NCCN Task Force Report: Oral Chemotherapy. Presented at: NCCN 13th Annual Conference; March 5-9, 2008; Hollywood, Fla.