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Erschienen in:

06.10.2022 | Clinical trial

Patient-centered dosing: oncologists’ perspectives about treatment-related side effects and individualized dosing for patients with metastatic breast cancer (MBC)

verfasst von: Anne L. Loeser, Lucy Gao, Aditya Bardia, Mark E. Burkard, Kevin M. Kalinsky, Jeffrey Peppercorn, Hope S. Rugo, Martha Carlson, Janice Cowden, Lesley Glenn, Julia Maues, Sheila McGlown, Andy Ni, Natalia Padron, Maryam Lustberg

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2022

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Abstract

Purpose

Although metastatic breast cancer (MBC) is treatable, it is not curable and most patients remain on treatment indefinitely. While oncologists commonly prescribe the recommended starting dose (RSD) from the FDA-approved label, patient tolerance may differ from that seen in clinical trials. We report on a survey of medical oncologists’ perspectives about treatment-related toxicity and willingness to discuss flexible dosing with patients.

Methods

We disseminated a confidential survey via social media/email in Spring 2021. Eligible respondents needed to be US-based medical oncologists with experience treating patients with MBC.

Results

Of 131 responses, 119 were eligible. Physicians estimated that 47% of their patients reported distressing treatment-related side effects; of these, 15% visited the Emergency Room/hospital and 37% missed treatment. 74% (n = 87) of doctors reported improvement of patient symptoms after dose reduction. 87% (n = 104) indicated that they had ever, if appropriate, initiated treatment at lower doses. Most (85%, n = 101) respondents did not believe that the RSD is always more effective than a lower dose and 97% (n = 115) were willing to discuss individualized dosing with patients.

Conclusion

Treatment-related side effects are prevalent among patients with MBC, resulting in missed treatments and acute care visits. To help patients tolerate treatment, oncologists may decrease initial and/or subsequent doses. The majority of oncologists reject the premise that a higher dose is always superior and are willing to discuss individualized dosing with patients. Given potential improvements regarding quality of life and clinical care, dose modifications should be part of routine shared decision-making between patients and oncologists.

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Titel: Patient-centered dosing: oncologists’ perspectives about treatment-related side effects and individualized dosing for patients with metastatic breast cancer (MBC)
verfasst von: Anne L. Loeser
Lucy Gao
Aditya Bardia
Mark E. Burkard
Kevin M. Kalinsky
Jeffrey Peppercorn
Hope S. Rugo
Martha Carlson
Janice Cowden
Lesley Glenn
Julia Maues
Sheila McGlown
Andy Ni
Natalia Padron
Maryam Lustberg
Publikationsdatum: 06.10.2022
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2022
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-022-06755-5

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Patient-centered dosing: oncologists’ perspectives about treatment-related side effects and individualized dosing for patients with metastatic breast cancer (MBC)