Patient-reported preferences for oral versus intravenous administration for the treatment of cancer: a review of the literature

Daniel Eek,1 Meaghan Krohe,2 Iyar Mazar,2 Alison Horsfield,3 Farrah Pompilus,2 Rachel Friebe,2 Alan L Shields2 1AstraZeneca, Gothenburg, Sweden; 2Adelphi Values, Boston, MA, USA; 3AstraZeneca, Macclesfield, UK Objective: The emergence of various modes of administration for cancer treatment, including oral administration, brings into focus the importance of patient preference for administration. The purpose of this research was to evaluate the administration preferences of cancer patients, specifically between oral and intravenous (IV) treatment, as well as the factors contributing to preference. Methods: A literature search was conducted in OvidSP to identify research in which the preferences of cancer patients for oral or IV treatment have been evaluated. Data were analyzed in two stages: 1) those articles that directly compared preference between modes of administration were tallied to determine explicit preference for oral or IV treatment; and 2) all attributes associated with patient preference were documented. Results: Of the 48 abstracts identified as part of the initial OvidSP search, eight articles were selected for full-text review. One article was removed following full-text review, and seven additional articles were identified through a gray literature search, yielding a total of 14 articles for evaluation. In Stage 1, 13 of the 14 articles compared preference, of which eleven articles (84.6%) reported that patients preferred oral treatment over IV, while two (15.4%) stated that cancer patients preferred IV treatment over oral. In Stage 2, the most frequently reported attributes contributing to preference included convenience, ability to receive treatment at home, treatment schedule, and side effects. Discussion: Evidence suggests that oncology patients prefer oral treatment to IV. Rationale for preference was due to a number of factors, including convenience, perception of efficacy, and past experience. Further evaluation should be conducted, given the limited data on patient preference in oncology. Keywords: oncology, patient preference, mode of administration, literature review, mode of administration, oncology, treatmen

Thermotectonic evolution of an extensional dome : the cenozoic Osogovo-Lisets core complex (Kraishte zone, western Bulgaria)

The Kraishte region of Bulgaria is located at the junction of the Balkanides and Hellenides-Dinarides tectonic belts. Fission-track analysis on both apatites and zircons documents the Cenozoic exhumation of a Precambrian basement bounded by low-angle detachments. Late Eocene - Oligocene extension began prior to 47 Ma and was dominantly in a top-to-the-southwest direction, confirmed by the sense of younging of apatite and zircon ages. This crustal extension controlled the formation of half-graben sedimentary basins on the hanging walls of the detachments. Thermal modelling of these hanging wall units provides evidence for heat transfer across the detachments from a relatively warm rising footwall. From 32 to 29 Ma, pervasive magmatic activity resulted in the emplacement of rhyolitic to dacitic subvolcanic bodies and dykes, along with intrusion of the Osogovo granite. The results give evidence for extension in the southern Balkan older than, and separated from, the Miocene to Quaternary Aegean extension. This might reflect transtension during northeastward extrusion and rotation of continental fragments around the western boundary of Moesia. Eocene - Oligocene extension seems to have been controlled by the distribution of earlier thickening all around the Carpatho-Balkanic orocline, which is reflected by the Cretaceous emplacement of the Morava Nappe in the Kraishte