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. 2016 Feb 22:16:135.
doi: 10.1186/s12885-016-2084-9.

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study

Nuria Lainez  1 , Jesús García-Donas  2 , Emilio Esteban  3 , Javier Puente  4 , M Isabel Sáez  5 , Enrique Gallardo  6 , Álvaro Pinto-Marín  7 , Sergio Vázquez-Estévez  8 , Luis León  9 , Icíar García-Carbonero  10 , Cristina Suárez-Rodríguez  11 , Carmen Molins  12 , Miguel A Climent-Duran  13 , Martín Lázaro-Quintela  14 , Aranzazu González Del Alba  15 , María José Méndez-Vidal  16 , Isabel Chirivella  17 , Francisco J Afonso  18 , Marta López-Brea  19 , Nuria Sala-González  20 , Montserrat Domenech  21 , Laura Basterretxea  22 , Carmen Santander-Lobera  23 , Irene Gil-Arnáiz  24 , Ovidio Fernández  25 , Cristina Caballero-Díaz  26 , Begoña Mellado  27 , David Marrupe  28 , José García-Sánchez  29 , Ricardo Sánchez-Escribano  30 , Eva Fernández Parra  31 , José C Villa Guzmán  32 , Esther Martínez-Ortega  33 , María Belén González  34 , Marina Morán  35 , Beatriz Suarez-Paniagua  36 , María J Lecumberri  37 , Daniel Castellano  38
Affiliations

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study

Nuria Lainez et al. BMC Cancer. .

Abstract

Background: The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice.

Methods: Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle.

Results: Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7% out of 966 post-implementation cycles compared with 23.1% out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33% pre-implementation vs. 44.5% post-implementation cycles; p < 0.0001), diarrhea (74.0% vs. 80.5%; p = 0.011) and dyslipemia (25.0% vs. 44.6%; p < 0.001).

Conclusions: Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.

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Figures

Fig. 1
Fig. 1
Patient distribution: Patients were recruited during the year before (between March 2010 and February 2011; pre-guidelines population) or the year after (between January 2012 and December 2012; post-guideline population) the publication, diffusion and implementation of the SOGUG Guideline program
Fig. 2
Fig. 2
Adherence to SOGUG Guidelines according to hospital category defined as number of cases diagnosed with renal cancer per year (c/y): 1st category hospital (≥ 20 c/y); 2nd category hospital (11–19) c/y and 3rd category hospital (0 to 10 c/y)
See this image and copyright information in PMC

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