Journal article
The Right Dose: Results of a Patient Advocate-Led Survey of Individuals With Metastatic Breast Cancer Regarding Treatment-Related Side Effects and Views About Dosage Assessment to Optimize Quality of Life
JCO oncology practice, Vol.20(7), pp.OP2300539-983
07/01/2024
DOI: 10.1200/OP.23.00539
PMID: 38518184
Abstract
PURPOSEAlthough patients with metastatic breast cancer (MBC) have been living longer with the advent of more effective treatments such as targeted therapy and immunotherapy, the disease remains incurable, and most patients will undergo therapy indefinitely. When beginning therapy, patients are typically prescribed dose often based upon the maximum tolerated dose identified in phase I clinical trials. However, patients' perspectives about tolerability and willingness to discuss individualized dosing of drugs upon initiation of a new regimen and throughout the course of treatment have not been comprehensively evaluated.METHODSPatient advocates and medical oncologists from the Patient-Centered Dosing Initiative (PCDI) developed a survey to ascertain the prevalence and severity of MBC patients' treatment-related side effects, the level of patient-physician communication, mitigation strategies, perception about the relative efficacy of higher versus lower doses, and willingness to discuss alternative dosing. The PCDI distributed the anonymous confidential online survey in August 2020 to individuals with self-reported MBC.RESULTSOne thousand and two hundred twenty-one patients with MBC completed the survey. 86.1% (n = 1,051) reported experiencing at least one significant treatment-related side effect, and of these, 20.3% (n = 213) visited the emergency room/hospital and 43.2% (n = 454) missed at least one treatment. Nearly all patients with side effects (97.6%, n = 1,026) informed their doctor and 81.7% (n = 838) received assistance. Of the 556 patients given a dose reduction for side-effect mitigation, 82.6% (n = 459) reported relief. Notably, majority of patients (53.3%, n = 651) do not believe that higher dose is always more effective than lower dose, and 92.3% (n = 1,127) would be willing to discuss flexible dosing options with their physicians based upon personal characteristics to optimize quality of life.CONCLUSIONGiven that the majority of patients with MBC experienced at least one substantial treatment-related side effect and most patients given a dose reduction reported improvement, innovative dosage-related strategies are warranted to sustain and improve patients' well-being. Patient-physician discussions in which the patient's unique attributes and circumstances are assessed upon initiation of new treatment and throughout the course of therapy may facilitate the identification of the most favorable dose for each patient, and the majority of patients would be receptive to this approach.
Details
- Title: Subtitle
- The Right Dose: Results of a Patient Advocate-Led Survey of Individuals With Metastatic Breast Cancer Regarding Treatment-Related Side Effects and Views About Dosage Assessment to Optimize Quality of Life
- Creators
- Anne Loeser - Patient Ctr Dosing Initiat, New York, NY USAJanice S. Kim - Massachusetts General HospitalJeffrey Peppercorn - Massachusetts General HospitalMark E. Burkard - University of Wisconsin–MadisonAndrzej Niemierko - Massachusetts General HospitalDejan Juric - Massachusetts General HospitalKevin Kalinsky - Emory UniversityHope Rugo - University of California San Francisco Medical CenterLesley Glenn - Patient Ctr Dosing Initiat, New York, NY USAChristine Hodgdon - Patient Ctr Dosing Initiat, New York, NY USAJulia Maues - Patient Ctr Dosing Initiat, New York, NY USASheila Johnson - Patient Ctr Dosing Initiat, New York, NY USANatalia Padron - Patient Ctr Dosing Initiat, New York, NY USAKimberly Parekh - Patient Ctr Dosing Initiat, New York, NY USAMaryam Lustberg - Yale School of MedicineAditya Bardia - UCLA Jonsson Comprehensive Cancer Center
- Resource Type
- Journal article
- Publication Details
- JCO oncology practice, Vol.20(7), pp.OP2300539-983
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1200/OP.23.00539
- PMID
- 38518184
- ISSN
- 2688-1527
- eISSN
- 2688-1535
- Number of pages
- 15
- Language
- English
- Date published
- 07/01/2024
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984701257702771
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