Supportive Care in Cancer

, Volume 22, Issue 10, pp 2677–2685 | Cite as

A pilot study: dose adaptation of capecitabine using mobile phone toxicity monitoring — supporting patients in their homes

  • Andrew Weaver
  • Sharon B. Love
  • Mark Larsen
  • Milensu Shanyinde
  • Rachel Waters
  • Lisa Grainger
  • Vanessa Shearwood
  • Claire Brooks
  • Oliver Gibson
  • Annie M. Young
  • Lionel Tarassenko
Original Article

Abstract

Purpose

Real-time symptom monitoring using a mobile phone is potentially advantageous for patients receiving oral chemotherapy. We therefore conducted a pilot study of patient dose adaptation using mobile phone monitoring of specific symptoms to investigate relative dose intensity of capecitabine, level of toxicity and perceived supportive care.

Methods

Patients with breast or colorectal cancer receiving capecitabine completed a symptom, temperature and dose diary twice a day using a mobile phone application. This information was encrypted and automatically transmitted in real time to a secure server, with moderate levels of toxicity automatically prompting self-care symptom management messages on the screen of the patient’s mobile phone or in severe cases, a call from a specialist nurse to advise on care according to an agreed protocol.

Results

Patients (n = 26) completed the mobile phone diary on 92.6 % of occasions. Twelve patients had a maximum toxicity grade of 3 (46.2 %). The average dose intensity for all patients as a percentage of standard dose was 90 %. In eight patients, the dose of capecitabine was reduced, and in eight patients, the dose of capecitabine was increased. Patients and healthcare professionals involved felt reassured by the novel monitoring system, in particular, during out of hours.

Conclusion

It is possible to optimise the individual dose of oral chemotherapy safely including dose increase and to manage chemotherapy side effects effectively using real-time mobile phone monitoring of toxicity parameters entered by the patient.

Keywords

Chemotherapy Dose decrease Dose increase Managing side effects Mobile phone technology 

Supplementary material

520_2014_2224_MOESM1_ESM.doc (165 kb)
ESM 1(DOC 165 kb)

References

  1. 1.
    Brearley S et al (2010) Clinical features of oral chemotherapy: results of a longitudinal prospective study of breast and colorectal cancer patients receiving capecitabine in the UK. Eur J Cancer Care 19(4):425–433CrossRefGoogle Scholar
  2. 2.
    Lyman GH et al (2004) Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin’s lymphoma: a nationwide study. J Clin Oncol 22(21):4302–4311PubMedCrossRefGoogle Scholar
  3. 3.
    Citron ML (2004) Dose-density in adjuvant chemotherapy for breast cancer. Cancer Investig 22(4):555–568CrossRefGoogle Scholar
  4. 4.
    Kimmel SRM, Kimmig R, Schmid P (2007) Dose-dense chemotherapy for primary breast cancer. Curr Opin Obstet Gynecol 19(1):75–81CrossRefGoogle Scholar
  5. 5.
    Evans WE et al (1998) Conventional compared with individualized chemotherapy for childhood acute lymphoblastic leukemia. N Engl J Med 338(8):499–505PubMedCrossRefGoogle Scholar
  6. 6.
    Department of Health (2013) NHS Improvement and Macmillan Cancer Support, Living with & beyond cancer: taking action to improve outcomes. Department of HealthGoogle Scholar
  7. 7.
    Weaver A et al (2007) Application of mobile phone technology for managing chemotherapy-associated side effects. Ann Oncol 18:1887–1892PubMedCrossRefGoogle Scholar
  8. 8.
    UKONS Oncology/haematology 24 hour triage rapid assessment and access tool kit. 2011. [online]. 2011 [cited 2013 01 February ]; Available from: <http://ukons.org/>
  9. 9.
    Adams R et al (2009) Toxicity associated with combination oxaliplatin plus fluoropyrimidine with or without cetuximab in the MRC COIN trial experience. Br J Cancer 100(2):251–258PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Cassidy J et al (2008) Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol 26(12):2006–2012PubMedCrossRefGoogle Scholar
  11. 11.
    Chang H et al (2011) Adjuvant chemotherapy using a tailored-dose strategy in elderly patients with colon cancer. Ann Oncol 23(4):911–918PubMedCrossRefGoogle Scholar
  12. 12.
    NCAG National chemotherapy advisory group, chemotherapy services in England: ensuring quality and safety. 2009. [online]. [Date accessed 01st February 2013]. Available from world wide web: <http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/DH_104500> 2009

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Andrew Weaver
    • 1
  • Sharon B. Love
    • 2
  • Mark Larsen
    • 3
  • Milensu Shanyinde
    • 2
  • Rachel Waters
    • 2
  • Lisa Grainger
    • 1
  • Vanessa Shearwood
    • 1
  • Claire Brooks
    • 4
  • Oliver Gibson
    • 3
  • Annie M. Young
    • 5
  • Lionel Tarassenko
    • 3
  1. 1.Oxford University Hospitals NHS TrustOxfordUK
  2. 2.Centre for Statistics in Medicine, Botnar Research CentreUniversity of OxfordOxfordUK
  3. 3.Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
  4. 4.Oncology Clinical Trials OfficeUniversity of OxfordOxfordUK
  5. 5.Division of Health SciencesWarwick Medical SchoolCoventryUK

Personalised recommendations