Improving adherence to CDK4/6 inhibitors in breast cancer through remote therapeutic monitoring with real-time adherence tracking and actionable alerts.

Abstract

e12520 Background: Oral CDK 4/6 inhibitors (CDK4/6is) have transformed the management of HR+/HER2- breast cancer (BC), offering patients (pts) greater flexibility and convenience. However, this places significant responsibility on pts to maintain adherence and manage treatment-related adverse events (TRAEs). This pilot study evaluated the impact of a digital adherence tool designed to facilitate remote monitoring and enhance adherence to CDK4/6is. Methods: In 2024, three health systems piloted a novel remote therapeutic monitoring technology, Tappt Health, customized to BC patients. Pts received near-field communication-enabled smart labels to affix to their medication containers, enabling them to record timing of each dose by tapping their phones. The smart labels were linked to pts’ unique medication schedules and notifications were sent for missed doses. Pt-reported outcomes surveys were incorporated in the app to assess AEs and adherence over 12 weeks. Oncology care teams were alerted if medication adherence dropped below 80%, or when pts experienced bothersome AEs or social determinants of health (SDOH) that impacted adherence. In response to pt alerts, care teams provided real-time remote support, AE management, dose adjustments, and referrals. Results: Altogether, 92 BC pts on CDK4/6is consented to use of Tappt Health. Adherence data were collected for 78 pts who participated in remote monitoring for at least 12 weeks (56% early-stage). Overall, 34% pts triggered an adherence alert and 35% triggered an AE alert. Overall, the most common AEs included menopausal symptoms such as insomnia and hot flashes (59%), extreme fatigue (33%), and severe diarrhea (25%). Additionally, 23% of pts reported experiencing SDOH that impacted health, most commonly economic hardship or unemployment (15%), social isolation or limited access to transportation (8%), and gaps in insurance coverage (3%). In response to the 276 alerts that were triggered, care teams offered real-time support through pt communication and outreach (27%), dose adjustments or additional treatments/supportive care (19%), and referrals to social workers or care navigators (4%, 1%). During the study period, overall adherence was 91%. Conclusions: Remote monitoring with real-time adherence tracking, actionable alerts, AE management, and support for addressing SDOH can enable care teams to intervene promptly, potentially improving adherence to oral anticancer therapies, including CDK4/6 inhibitors, in HR+/HER2- BC patients. These findings underscore the value of digital health tools and remote monitoring in supporting adherence to oral oncology treatments and support further study in this area.