Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study
Por:
Lainez, N, Garcia-Donas, J, Esteban, E, Puente, J, Isabel Saez, M, Gallardo, E, Pinto-Marin, A, Vazquez-Estevez, S, Leon, L, Garcia-Carbonero, I, Suarez-Rodriguez, C, Molins, C, Climent-Duran, M, Lazaro-Quintela, M, Gonzalez del Alba, A, Jose Mendez-Vidal, M, Chirivella, I, Afonso, F, Lopez-Brea, M, Sala-Gonzalez, N, Domenech, M, Basterretxea, L, Santander-Lobera, C, Gil-Arnaiz, I, Fernandez, O, Caballero-Diaz, C, Mellado, B, Marrupe, D, Garcia-Sanchez, J, Sanchez-Escribano, R, Fernandez Parra, E, Villa Guzman, J, Martinez-Ortega, E, Belen Gonzalez, M, Moran, M, Suarez-Paniagua, B, Lecumberri, M and Castellano, D
Publicada:
22 feb 2016
Resumen:
Background: The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice.
Methods: Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle.
Results: Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7 % out of 966 post-implementation cycles compared with 23.1 % out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33 % pre-implementation vs. 44.5 % post-implementation cycles; p < 0.0001), diarrhea (74.0 % vs. 80.5 %; p = 0.011) and dyslipemia (25.0 % vs. 44.6 %; p < 0.001).
Conclusions: Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.
Filiaciones:
Lainez, N:
Complejo Hosp Navarra, Dept Oncol, Med Oncol Serv, Hosp Dia, Pabellon B 2a Planta,C Irunlarrea 3, Navarra 31008, Spain
Garcia-Donas, J:
Hosp Sanchinarro, Dept Oncol, C Ona 10, Madrid 28050, Spain
Esteban, E:
Hosp Univ Cent Asturias, Dept Oncol, Oviedo 33006, Spain
Puente, J:
Hosp Clin Madrid, Dept Oncol, C Doctor Martin Lagos S-N, Madrid 28040, Spain
Isabel Saez, M:
Hosp Univ Clin Virgen de la Victoria, Dept Oncol, Campus Univ Teatinos S-N, Malaga, Spain
Gallardo, E:
Parc Tauli Sabadell Hosp Univ, Dept Oncol, Parc Tauli 1, Sabadell 08208, Spain
Pinto-Marin, A:
Hosp Univ La Paz, Dept Oncol, Castellana 261, Madrid 28046, Spain
Vazquez-Estevez, S:
Hosp Univ Lucus Augusti, Dept Oncol, Lugar San Cibrao S-N, Lugo 27003, Spain
Leon, L:
Hosp Santiago de Compostela, Dept Oncol, Travesia Choupana S-N, Santiago De Compostela 15706, Spain
Garcia-Carbonero, I:
Hosp Virgen de la Salud, Dept Oncol, Adva Barber 30, Toledo 45004, Spain
Suarez-Rodriguez, C:
Hosp Valle De Hebron, Dept Oncol, Ps Vall dHebron 119-129, Barcelona 8035, Spain
:
Hosp Univ Dr Peset, Dept Oncol, Avda Gaspar Aguilar 90, Valencia 46017, Spain
Climent-Duran, M:
Inst Valenciano Oncol, Dept Oncol, 31-1 Planta, Valencia 46009, Spain
Lazaro-Quintela, M:
Complexo Hosp Univ Vigo, Dept Oncol, Pizarro 22, Vigo 36204, Spain
Gonzalez del Alba, A:
Hosp Univ Son Espases, Dept Oncol, Ctra Valldemossa 79, Palma De Mallorca 07010, Spain
Jose Mendez-Vidal, M:
Hosp Univ Reina Sofia, Dept Oncol, Avda Menendez Pidal S-N, Cordoba 14004, Spain
Chirivella, I:
Hosp Clin Valencia, Dept Oncol, Avda Blasco Ibanez 17, Valencia 46010, Spain
Afonso, F:
Complejo Hosp Arquitecto Marcide, Dept Oncol, Rua Residencia S-N, San Pedro De Leixa 15405, Ferrol, Spain
Lopez-Brea, M:
Hosp Marques de Valdecilla, Dept Oncol, Avda Valdecila S-N, Santander 39008, Spain
Sala-Gonzalez, N:
ICO Girona, Dept Oncol, Francia S-N, Girona 17007, Spain
Domenech, M:
Hosp Althaia Xarxa Asistencial Manresa, Dept Oncol, Dr Joan Soler 1-3, Barcelona 08243, Spain
Basterretxea, L:
Hosp Donostia, Dept Oncol, P Dr Beguiristain 109, San Sebastian 20014, Spain
Santander-Lobera, C:
Hosp Miguel Servet, Dept Oncol, Avda Gomez Laguna 25, Zaragoza 50009, Spain
Gil-Arnaiz, I:
Hosp Reina Sofia, Dept Oncol, Carretera Tarazona,KM 3, Tudela 31500, Spain
Fernandez, O:
Hosp Santa Maria Nai, Complejo Hosp Ourense, Dept Oncol, Ramon Puga 52-54, Orense 32005, Spain
Caballero-Diaz, C:
Hosp Gen Univ Valencia, Dept Oncol, Avda Tres Cruces S-N, Valencia 46014, Spain
Mellado, B:
Hosp Clin Barcelona, Dept Oncol, IDIBAPS, Villarroel 170, Barcelona 08036, Spain
Marrupe, D:
Hosp Univ Mostoles, Dept Oncol, Rio Jucar S-N, Madrid 28935, Spain
:
Hosp Arnau Vilanova, Dept Oncol, C San Clemente 12, Valencia 46015, Spain
Sanchez-Escribano, R:
Hosp Univ Burgos, Dept Oncol, Ave Cid Campeador 96, Burgos 09005, Spain
Fernandez Parra, E:
Hosp Univ Hosp Valme, Dept Oncol, Ctra Cadiz Km 548-9, Seville 41014, Spain
Villa Guzman, J:
Hosp Ciudad Real, Dept Oncol, Ciudad Real 13005, Spain
Martinez-Ortega, E:
Hosp Ciudad Jaen, Dept Oncol, Ave Ejercito Espanol 1, Jaen 23007, Spain
Belen Gonzalez, M:
Hosp Son Llatzer, Dept Oncol, Ctra Manacor,Km 4, Palma De Mallorca 07198, Spain
Moran, M:
Pfizer Madrid, Avda Europa 20B, Madrid 28108, Spain
Suarez-Paniagua, B:
Trial Form Support, Avda Europa 20B, Madrid 28108, Spain
Lecumberri, M:
Complejo Hosp Navarra, Dept Oncol, Med Oncol Serv, Hosp Dia, Pabellon B 2a Planta,C Irunlarrea 3, Navarra 31008, Spain
Castellano, D:
Hosp 12 Octubre, Dept Oncol, Av Cordoba S-N, E-28041 Madrid, Spain
Green Published, gold
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