Mitigating Adverse Events With Bosutinib Treatment in CML
Posted: Tuesday, February 12, 2019
According to a review published in the Journal of Hematology & Oncology, several strategies are available to mitigate the adverse effects associated with bosutinib treatment in patients with chronic-phase chronic myeloid leukemia (CP-CML) and enhance patience adherence to the treatment.
“Patient education of goals and known [adverse events], and optimum communication with patients throughout the course of therapy, may help management of [adverse events], as well as gain their support for dose escalations, when needed, to optimize the efficacy of therapy,” concluded Jorge E. Cortes, MD, of MD Anderson Cancer Center, and colleagues.
An expert panel of hematologists reviewed management strategies for adverse events associated with bosutinib therapy in the BFORE trial, a 2017 study of the first-line administration of the treatment in patients with CP-CML. Although this clinical trial confirmed the efficacy of bosutinib, it also identified several common adverse events experienced by patients treated with this agent, including diarrhea, nausea and vomiting, renal dysfunction, and myelosuppression. The panel members sought to determine management methods other than dose reduction to encourage continued compliance. Recommendations for bosutinib adverse events included suggestions intended for implementation both prior to and during treatment.
Many of the panel’s recommendations focused on patient education, including dietary guidelines, hydration advice, and expectation management regarding common side effects.
The experts also suggested obtaining complete blood cell counts and measuring certain factors, such as renal function, risk of arterio-occlusive disease, and risk of cardiovascular events, prior to treatment and again periodically during therapy. For most adverse events, the panel recommended excluding causes unrelated to the use of bosutinib, avoiding substances known to compound ill effects, and treating the symptoms of the adverse events as primary courses of action.
Disclosure: The study authors’ disclosure information may be found at biomedcentral.com.