Journal article
Patient-centered dosing: oncologists' perspectives about treatment-related side effects and individualized dosing for patients with metastatic breast cancer (MBC)
Breast cancer research and treatment, Vol.196(3), pp.549-563
12/01/2022
DOI: 10.1007/s10549-022-06755-5
PMID: 36198984
Abstract
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.
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.
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.
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.
Details
- Title: Subtitle
- Patient-centered dosing: oncologists' perspectives about treatment-related side effects and individualized dosing for patients with metastatic breast cancer (MBC)
- Creators
- Anne L Loeser - Patient-Centered Dosing Initiative, Salt Lake City, UT, USALucy Gao - Yale School of MedicineAditya Bardia - Harvard Medical SchoolMark E Burkard - University of Wisconsin Carbone Cancer CenterKevin M Kalinsky - Winship Cancer InstituteJeffrey Peppercorn - Harvard Medical SchoolHope S Rugo - University of California, San FranciscoMartha Carlson - Patient-Centered Dosing Initiative, Salt Lake City, UT, USAJanice Cowden - Patient-Centered Dosing Initiative, Salt Lake City, UT, USALesley Glenn - Patient-Centered Dosing Initiative, Salt Lake City, UT, USAJulia Maues - Patient-Centered Dosing Initiative, Salt Lake City, UT, USASheila McGlown - Patient-Centered Dosing Initiative, Salt Lake City, UT, USAAndy Ni - The Ohio State UniversityNatalia Padron - Patient-Centered Dosing Initiative, Salt Lake City, UT, USAMaryam Lustberg - Smilow Cancer Hospital
- Resource Type
- Journal article
- Publication Details
- Breast cancer research and treatment, Vol.196(3), pp.549-563
- DOI
- 10.1007/s10549-022-06755-5
- PMID
- 36198984
- ISSN
- 0167-6806
- eISSN
- 1573-7217
- Language
- English
- Date published
- 12/01/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984701259202771
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