What are the needs in oral antitumor therapy? An analysis of patients' and practitioners' preferences.

Autor:	Hester A; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany., Henze F; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany., Debes AM; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany., Schubert CL; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany., Koenig A; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany., Harbeck N; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany., Wuerstlein R; Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCC) Munich, University Hospital, LMU Munich, Munich, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 Jun 27; Vol. 14, pp. 1388087. Date of Electronic Publication: 2024 Jun 27 (Print Publication: 2024).
DOI:	10.3389/fonc.2024.1388087
Abstrakt:	Background: Since the European approval of CDK4/6 inhibitors in 2016, the treatment of patients with hormone-receptor-positive, HER2-negative metastatic breast cancer has changed significantly. Compared with chemotherapy, endocrine-based therapy has different treatment regimens and is associated with new side effects. Oral therapy aims for optimal drug efficacy and long treatment times while maintaining maximum independence and quality of life resulting in the conservation of medical staff resources. Methods: A monocentric analysis of therapy preferences of practitioners (25 nurses and physicians) and patients (11 on endocrine monotherapy, 17 on endocrine-based therapy, and 14 on intravenous chemotherapy) was performed using specific questionnaires. Preferences were assessed using a four-point Likert scale or bidirectional response options. Results: All patients were highly supportive of oral therapy (mean agreement score on the Likert scale 1.3, p < 0.001 vs . all other options) and a consultation interval of 4 weeks (2.0, p = 0.015 vs . 3 weeks). Practitioners also preferred oral therapy (1.4) and visits every 4 weeks (1.6). In general, patients on oral therapies reported higher compatibility of their therapy with daily life than patients on chemotherapy (1.6 and 1.7 vs . 2.6, p = 0.006). Outpatient oncology is the main source of information for all patients, mainly in case of side effects (2.0) and open questions (1.8). Regarding oral antitumor therapy regimens, patients do not show a significant preference for a specific regimen, while practitioners prefer a continuous regimen (1.6) over a 21/7 regimen (21 days on and 7 days off therapy, 2.5). Patients are likely to accept mild side effects (e.g., neutropenia, diarrhea, polyneuropathy, fatigue) and would still adhere to their initial choice of regimen (continuous or 21/7). Only when side effects occur with a severity of CTCAE grade 3 do patients prefer the regimen in which the side effects occur for a shorter period of time. Conclusion: Patients and practitioners prefer oral antitumor therapy-both continuous and 21/7 regimens-over other application forms. Patient education and proper therapy management, supported by additional tools, contribute to the specific management of side effects and high adherence. This allows quality of life to be maintained during long-term therapy with CDK4/6 inhibitors in patients with metastatic breast cancer. Competing Interests: AH received honoraria for advisory boards and lectures and support for training programs/congress participation from Roche, Pfizer, Gilead and Sandoz/Hexal. RW reports potential COIs with Agendia, Amgen, Aristo, Astra Zeneca, Boeringer Ingelheim, Carl Zeiss, Celgene, Clovis Oncology, Daiichi-Sankyo, Eisai, Exact Sciences, Genomic Health, Gilead, Glaxo Smith Kline, Hexal, Lilly, Medstrom Medical, MSD, Mundipharma, Mylan, Nanostring, Novartis, Odonate, Paxman, Palleos, Pfizer, Pierre Fabre, PINK, PumaBiotechnolgogy, Riemser, Roche, Sandoz/Hexal, Sanofi Genzyme, Seattle Genetics/Seagen, Stemline, Tesaro Bio, Teva, Veracyte, Viatris, FOMF, Aurikamed, Clinsol, Pomme Med, medconcept, MCI. NH reports honoraria for lectures and/or consulting from: Amgen, AstraZeneca, Daiichi-Sankyo, Gilead, Lilly, MSD, Novartis, Pierre-Fabre, Pfizer, Roche, Sandoz, and Seagen. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (Copyright © 2024 Hester, Henze, Debes, Schubert, Koenig, Harbeck and Wuerstlein.)
Databáze:	MEDLINE
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