MDS/Neoplasms: Time Toxicity for Patients Receiving Oral Versus Parenteral HMAs

Patients undergoing cancer treatment, particularly those with higher-risk myelodysplastic syndromes (MDS) and neoplasms receiving hypomethylating agents (HMAs), often spend a significant amount of time in clinics. The median life expectancy for these patients is between 11 and 17 months. Understanding the time burden of treatments, or “time toxicity,” is crucial for clinicians to guide on alternative administration routes for patients and caregivers.

Oral HMA therapies have been developed to reduce clinic time, allowing patients more “home days.” This study shows the time burden among patients with MDS/neoplasms receiving oral HMA therapy versus those receiving intravenous and subcutaneous (IV/SC) HMAs.

This study retrospectively analyzed adult patients with MDS/neoplasms who underwent HMA therapy (oral or IV/SC HMA). The data used for analysis were obtained from the US Cerner Enviza claims database. To account for potential confounding factors, propensity score matching was performed, matching cohorts of 158 patients each.

The evaluation focused on the total number of healthcare encounter days for patients receiving oral and IV/SC HMAs, considering parenteral HMA administration (0 days for oral HMAs), outpatient visits, inpatient stays, emergency room visits, and infusion days. Unique encounter days were included in the calculation, with multiple visits in a single day being de-duplicated. The mean (standard deviation) healthcare days for the oral and IV/SC HMA groups were calculated and summarized separately for each type of healthcare encounter.

Patients who were administered oral HMAs had an average of 15.2 healthcare encounter days, whereas those who received IV/SC HMAs had an average of 32.8 days. Most encounter days for the oral HMA group occurred in outpatient settings (34.9%), while for the IV/SC HMA group, most encounters were due to parenteral HMA administration (55.5%), followed by inpatient (16.2%) and outpatient (14.9%) visits.

The findings of this study, the first of its kind to address time toxicity in patients with MDS/neoplasms treated with HMA therapy, indicate that patients who received oral HMA treatment experienced a reduced time burden compared with those who received IV/SC HMAs. Further research is needed to validate these results in a larger patient group and to compare them with other cancer treatment options.

Source: Epstein RS, Zeidan AM, Olopoenia A, et al. Time toxicity for patients receiving oral versus parenteral hypomethylating agents for myelodysplastic syndromes/neoplasms. Chicago, IL, & online: presented at 2024 ASCO Annual Meeting; abstract 6568.