Drug Discov Ther. 2025;19(6):378-388. (DOI: 10.5582/ddt.2025.01095)

Real-world use of non-oral administration of oral anticancer agents via the simple suspension method in Japanese patients with cancer: A nationwide claims-based analysis

Ohta H, Yasu T

The enteral administration of drugs as suspensions is a potential alternative route for patients with dysphagia. The simple suspension method is commonly used in Japan; however, nationwide data are lacking. This study aimed to investigate the real-world use and potential impact of oral anticancer agent (OAA) suspensions in patients with dysphagia in Japan. A large Japanese administrative claims database was used in this retrospective study (April 2014 to August 2023). Patients with cancer who had nasogastric, gastrostomy, or jejunostomy tubes and received OAAs during non-oral intake periods were included. These periods were defined using procedural codes, and it was assumed that the prescribed drugs were suspended. Three frequently used drugs (temozolomide, lenvatinib, and osimertinib) were analyzed. Patients were divided into suspension and non-suspension groups using propensity score matching, and overall survival (OS) was compared using the Kaplan–Meier method. Among 25,252 patients with feeding tubes, 126 received OAAs during the non-oral period. The median age was 76 years, and 62% had gastrostomy tubes. Temozolomide was the most common drug suspension, followed by lenvatinib and osimertinib. No significant difference in OS was observed between the temozolomide and lenvatinib groups. However, OS of the osimertinib suspension group was shorter than that of the non-suspension group (p = 0.047). This large-scale study of OAA suspensions in Japan suggests that drug suspensions may support continued anticancer treatment in patients with dysphagia. However, drug stability and exposure risks should be considered. Further evidence and more specific guidelines are required to ensure safe and effective use.

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