We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A service evaluation at the Singleton Hospital (Swansea Bay University Health Board); Swansea, UK to examine capacity use (chair and treatment time) for metastatic colorectal cancer patients (mCRC) treated with EGFR therapies and chemotherapy.
- Authors
Lau, Eleanor; Neill, William
- Abstract
Background: Panitumumab and cetuximab are monoclonal antibodies that target the EGFR (epithelial growth factor receptor) and are used in the treatment of metastatic colorectal cancer (mCRC) that over-express EGFR.1 The Singleton Hospital uses both agents with chemotherapy and oncologists within the centre may choose either agent. However, there are differences in infusion time, need for pre-medication and dosing schedule.2 These differences affect the time that a patient occupies a treatment chair (‘chair time’) which then affects the number of patients that can be treated in a given clinic (‘capacity’).2 Objectives: To evaluate current capacity usage (chair time) for mCRC patients treated with targeted EGFR therapies in combination with chemotherapy, and to identify potential opportunities to increase capacity and inform decision-making.3 Method: Between January 2019 and December 2019, data were retrospectively collected from 20 electronic patient records. Patients were aged 18 and over, diagnosed with stage 4 mCRC with a RAS wild-type status and treated with at least two cycles of EGFR therapy in combination with chemotherapy. Patients received either, panitumumab (n = 4) or cetuximab (n = 16), in combination with folinic acid, fluorouracil and oxaliplatin (FOLFOX), or folinic acid, fluorouracil and irinotecan (FOLRIFI). All treatments were prescribed based on the clinician’s preference. For each patient, regimen and recorded chair time were collected. A comparison was made between the two agents in terms of the use of resources was conducted, in addition to an examination of allocated chair time versus recorded chair time. Results: Across the study period, 14 cycles of panitumumab were delivered (mean cycles per patient: 3.5±2.4) compared with 90 cycles of cetuximab (mean cycles per patient: 5.6± 2.2). Panitumumab was only combined with FOLFOX (n = 4 patients), whereas cetuximab was more frequently combined with FOLFIRI (n = 11 patients) compared with FOLFOX (n = 5 patients). It was estimated that if all patients following clinical assessment, received panitumumab, 135.0 h (or 16.9 chair days) could have been saved over the study period (8 h chair time available per day). Given the preference of combining panitumumab with FOLFOX2–4 rather than FOLFIRI, only n = 5 patients who received cetuximab combined with FOLFOX would potentially have received panitumumab, and the potential time saving would be 36.0 h (or 4.5 chair days) over a total of 24 treatment cycles. The total allocated chair time (816.0 h) was found to be 19% higher than the total recorded chair time (661.2 h), across the 104 cycles delivered during the study period. Moreover, panitumumab-based regimens had a greater difference between allocated chair time and recorded chair time, with total allocated chair time (105.0 h) being 24% greater than a total recorded chair (80.1 h) when compared with cetuximab. Total allocated chair time (711.0 h) for the cetuximab-based regimen was 18% greater than the total recorded chair time (581.1 h). Conclusion: The results of this analysis suggest that a panitumumab-based regimen has potential savings in terms of chair time. Furthermore, the total recorded chair time was found to be 19% less than the total allocated chair time. Optimising both aspects of the treatment procedure has the potential to increase capacity and patient flow.
- Subjects
ENGLAND; WALES; THERAPEUTIC use of monoclonal antibodies; THERAPEUTIC use of antineoplastic agents; PANITUMUMAB; EVALUATION of medical care; SPECIALTY hospitals; EPIDERMAL growth factor receptors; CANCER chemotherapy; METASTASIS; TREATMENT duration; CONFERENCES &; conventions; RETROSPECTIVE studies; COLORECTAL cancer; CANCER treatment; CANCER patients; DESCRIPTIVE statistics
- Publication
Journal of Oncology Pharmacy Practice, 2023, Vol 29, p89
- ISSN
1078-1552
- Publication type
Article
- DOI
10.1177/10781552231153542