Maurie Markman, MD
Antineoplastic drug therapy has been delivered by the oral route since the earliest days of the modern chemotherapeutic era. Examples include cyclophosphamide in breast cancer and melphalan in ovarian cancer. More recent experiences include an expanded use of oral hormonal therapy in several malignancies and a number of molecularly targeted therapeutics in routine clinical practice.
Conversely, nausea described in clinical trial analyses and subsequent peer-reviewed publications as being “low-grade” (grade 1) would likely be considered as having a limited or minimal impact on a patient’s overall quality of life and might even be classified as being “acceptable.”
Impact on Adherence
Now, fast forward to the current era where the paradigm is rapidly shifting to include highly clinically active orally administered antineoplastic drugs, where such therapy is routinely delivered daily or several times a day and where treatment may be continued for many years, either for a known active cancer or in a maintenance setting.
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