Dr Ferrajoli on Shared Decision-Making During BTK Inhibitor Selection in Hematologic Malignancies

Alessandra Ferrajoli, MD, hematologist/oncologist, associate professor of medicine, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the importance of involving patients in shared treatment decision-making when considering the use of acalabrutinib (Calquence) or other BTK inhibitors to manage hematologic malignancies.

Ferrajoli begins by stating that it is critical to engage in comprehensive discussions with patients about potential toxicities, monitoring requirements, and individual patient factors that may influence their outcomes with acalabrutinib or other BTK inhibitors. During consultations, Ferrajoli emphasizes the importance of understanding possible adverse effects and the necessary steps for appropriate monitoring. Patients are encouraged to actively participate by monitoring their blood pressure at home by maintaining a blood pressure log regularly, adjusting the frequency based on individual needs, Ferrajoli states. This allows their clinician to obtain a more accurate picture of their day-to-day measurements, considering factors like traffic and clinic-related anxiety that can impact in-office readings, she explains.

In cases of uncontrolled hypertension, daily monitoring should commence alongside active involvement of the patient's primary care physician or cardiologist, Ferrajoli continues. This is particularly important if there are multiple risk factors involved, she notes. For complex cardiovascular considerations related to cancer treatment, close engagement with cardio-oncologists, who specialize in managing patients on targeted therapies, should be prioritized, she adds. This collaborative approach ensures that patients receive comprehensive cardiovascular assessments and appropriate guidance for treatment decisions, including clearance for specific therapies or advice on managing treatment-related cardiovascular issues, Ferrajoli says. The goal is to optimize treatment outcomes and patient well-being through a holistic and well-informed approach that integrates both oncological and cardiovascular perspectives, she states.

By involving patients in shared decision-making and collaborating with multidisciplinary teams, healthcare providers ensure that treatment decisions prioritize patient preferences, safety, and overall well-being. This approach fosters a supportive and informed partnership between patients and healthcare providers, enhancing treatment adherence and optimizing outcomes in patients receiving BTK inhibitors for hematologic malignancies, Ferrajoli concludes.