TY - JOUR
T1 - Physician risk perceptions and surveillance practices for tyrosine kinase inhibitor long-term effects in pediatric CML
AU - Smith, Stephanie M.
AU - Zhang, Shiqi
AU - Sundaram, Vandana
AU - Roth, Michael
AU - Andolina, Jeffrey R.
AU - Schapira, Lidia
AU - Sakamoto, Kathleen M.
AU - Kolb, E. Anders
AU - Hijiya, Nobuko
AU - Chaudhury, Sonali
N1 - Funding Information:
NH reports consultancy for Novartis and Incyte and research funding from Pfizer. All other authors declare no competing financial interests.
Funding Information:
This work was supported by a Stanford Maternal and Child Health Research Institute “Rosa A. Wann and Marjorie Shannon Fellow” grant (SMS). Research reported in this publication was also supported by the Children’s Oncology Group, National Cancer Institute of the National Institutes of Health NCTN Operation Center Grant U10CA180886. The REDCap platform services at Stanford are subsidized by a) Stanford School of Medicine Research Office, and b) the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1 TR001085. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank the pediatric oncologists who completed the survey and the Children’s Oncology Group communications committee for their partnership in distributing the survey.
Publisher Copyright:
© 2021 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Chronic myeloid leukemia (CML) is effectively treated with long-term tyrosine kinase inhibitor (TKI) therapy, yet little is known about risks of prolonged TKI exposure in young patients, and long-term effect monitoring is not standardized. We surveyed North American pediatric oncologists (n = 119) to evaluate perceived risk of and surveillance practices for potential toxicities associated with prolonged TKI exposure in children and adolescents/young adults (AYAs) with CML. Survey domains included general and specific risk perceptions and surveillance practices for asymptomatic patients on chronic TKI therapy. We analyzed data descriptively and explored relationships between risk perceptions and surveillance. Risk perceptions varied among oncologists but were similar across six categories (thyroid, cardiac, vascular, metabolic, fertility, psychologic), with less than one-third rating each risk as moderate or high in pediatric and AYA patients. More oncologists perceived moderate or high risk of growth abnormalities in children (62% pediatric, 14% AYA) and financial toxicity in all patients (60% pediatric, 64% AYA). A greater proportion of oncologists with moderate or high perceived risk of thyroid abnormalities reported testing thyroid function compared to those with lower perceived risk; patterns for metabolic risk/lipid tests and cardiac risk/tests were similar. In summary, we found that pediatric oncologists had variable risk perceptions and surveillance practices for potential toxicities associated with prolonged TKI exposure. Standardizing surveillance would help quantify risks and refine recommendations. Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2021.2017085.
AB - Chronic myeloid leukemia (CML) is effectively treated with long-term tyrosine kinase inhibitor (TKI) therapy, yet little is known about risks of prolonged TKI exposure in young patients, and long-term effect monitoring is not standardized. We surveyed North American pediatric oncologists (n = 119) to evaluate perceived risk of and surveillance practices for potential toxicities associated with prolonged TKI exposure in children and adolescents/young adults (AYAs) with CML. Survey domains included general and specific risk perceptions and surveillance practices for asymptomatic patients on chronic TKI therapy. We analyzed data descriptively and explored relationships between risk perceptions and surveillance. Risk perceptions varied among oncologists but were similar across six categories (thyroid, cardiac, vascular, metabolic, fertility, psychologic), with less than one-third rating each risk as moderate or high in pediatric and AYA patients. More oncologists perceived moderate or high risk of growth abnormalities in children (62% pediatric, 14% AYA) and financial toxicity in all patients (60% pediatric, 64% AYA). A greater proportion of oncologists with moderate or high perceived risk of thyroid abnormalities reported testing thyroid function compared to those with lower perceived risk; patterns for metabolic risk/lipid tests and cardiac risk/tests were similar. In summary, we found that pediatric oncologists had variable risk perceptions and surveillance practices for potential toxicities associated with prolonged TKI exposure. Standardizing surveillance would help quantify risks and refine recommendations. Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2021.2017085.
KW - BCR-ABL
KW - chronic myeloid leukemia
KW - late effects
KW - long-term effects
KW - tyrosine kinase inhibitors
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U2 - 10.1080/08880018.2021.2017085
DO - 10.1080/08880018.2021.2017085
M3 - Article
C2 - 34918996
AN - SCOPUS:85121683042
SN - 0888-0018
VL - 39
SP - 453
EP - 467
JO - Pediatric hematology and oncology
JF - Pediatric hematology and oncology
IS - 5
ER -