Background: Targeted oral anticancer medications (T-OAMs) have improved outcomes in molecular sub-types of lung cancer, offering dosing convenience and better tolerability than intravenous chemotherapy. T-OAM bioavailability is altered through interaction with bio-active foods such as grapefruit or dose-timing relative to meals, risking over or under-dosing with higher toxicity or reduced effectiveness.
Aim: To investigate knowledge, awareness and avoidance of food-drug interactions (FDIs) in lung cancer patients on T-OAMs.
Methods: Single centre, non-randomised, multidisciplinary, qualitative study. Advanced lung cancer patients attending Westmead Hospital outpatient clinics prescribed T-OAMs for at least three months were invited to participate in a 30-minute semi-structured interview. Recruitment continued until data saturation. Interviews were transcribed verbatim and thematically analysed using NVivo®. Westmead Human research ethics committee approval was obtained (2019/ETH11743).
Results: Data saturation was reached after 11 interviews. Most participants were female (82%), age range was 45 to 90years and T-OAM treatment duration range was 4 to 90 months. Three key themes emerged: knowledge of FDIs, awareness of different information sources and preferences for information provision. In general, most participants were unaware of the interaction between T-OAMs and bioactive foods. Those aware of the FDI reported avoidance of relevant foods however, there was confusion regarding what foods were implicated. All participants recalled receiving written information on commencement of their T-OAM but none were aware of specific cautionary information such as ancillary labels on medication boxes. Participants highlighted the need for ongoing additional information and there was a strong preference for one-to-one education regarding their T-OAM early in their treatment.
Discussion: A strong need for ongoing patient education around T-OAMs and potential FDIs was found. Participants expressed a clear preference to receive written information resources, explained in detail by a health professional during face-to-face consultation and for ongoing educational support throughout their cancer treatment.