Assessment of Side Effects (SEs) Impacting Quality of Life (QOL) in Patients (Pts) Undergoing Treatment (tx) for Advanced Breast Cancer (ABC) in Clinical Practice: A Real-World (RW) Multicountry Survey

November 2022 Vol 13, No 11

Fatima Cardoso,1 Julie Rihani,2 Dawn Aubel,3 Joanna de Courcy,4 Victoria Harmer,5 Nadia Harbeck,6 Ana Casas,7 Hope S. Rugo,8 Peter A. Fasching,9 Sina Haftchenary,10 Purnima Pathak,3 Eva Schumacher-Wulf11

1Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal; 2King Hussein Cancer Center, Amman, Jordan; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 4Adelphi Real World, Cheshire, UK; 5Imperial College Healthcare NHS Trust, London, UK; 6Breast Center, Department of Obstetrics and Gynecology, LMU University Hospital Munich, Germany; 7University Hospital Virgen del Rocio, Sevilla, Spain; 8University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; 9University Hospital Erlangen, Comprehensive Cancer Center Erlangen–European Metropolitan Region of Nuremberg, and Department of Gynecology and Obstetrics, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany; 10Novartis Pharmaceuticals Canada, Montreal, Canada; 11Mamma Mia! Breast Cancer Magazine, Kronberg, Germany

Background: Gaps in RW evidence exist regarding pts’ and healthcare professionals’ (HCPs) perspectives on SEs impacting QOL. Previously, RW survey results showed disconnects between pts with ABC and HCPs on the importance of QOL discussions (Cardoso, SABCS 2021).

Objective: To examine how SEs impacting QOL in pts with ABC are perceived.

Methods: The survey was designed by a committee of oncologists, nurses, advocates, and pts. After ethical approval, data were collected from July 2020 to May 2021 via a cross-sectional online survey of oncologists, nurses, and pts with HR+/HER2– ABC in 7 countries. HCPs and pts were surveyed on the impact of SEs on QOL and HCP interactions. Observations were assessed using a 4-point Likert scale.

Results: The survey was completed by 467 pts and 502 HCPs. Most pts and HCPs believed fear of progression (76% and 92%, respectively) and pain (73% and 96%) had a moderate/severe impact on QOL. The most common SEs experienced by pts since starting ABC tx or their current tx were fatigue (73% and 64%) and pain (64% and 42% [back pain]). Fatigue relieved by rest was believed to have a moderate/severe impact on QOL more so by pts (78%) than HCPs (40%). Most pts did not discuss SEs with HCPs (79% for fatigue, 74% for pain) until these were moderate/severe. Pts reported that insomnia (83%), anxiety (82%), back pain (78%), fatigue (77%), and diarrhea (71%) had a moderate/severe impact on their QOL. Pts were least willing to live with back pain (52%), fatigue (42%), diarrhea (41%), and loss of appetite (41%) even if tx was working. In pts on a CDK4/6 inhibitor, 83% experienced ≥1 moderate/severe SE, with insomnia (85%), diarrhea (75%), back pain (75%), and fatigue (74%) having a moderate/severe impact on QOL.

Conclusions: Pts with ABC and HCPs were generally aligned on SEs that severely impacted QOL, but HCPs may undervalue the impact of mild SEs on pts. Fatigue and pain were the most common SEs experienced by pts. In pts on a CDK4/6 inhibitor, insomnia, diarrhea, back pain, and fatigue had a moderate/severe impact on QOL. These data support close monitoring, early intervention, and when indicated, prophylaxis of SEs that may greatly impact QOL in pts with ABC. Improved HCP, pt, and pt navigator awareness of these mild SEs could facilitate earlier communication of these events with HCPs, thereby enhancing pt QOL.

Funding: This study was sponsored by Novartis Pharma AG.

This abstract was previously presented at ESMO Breast Cancer 2022 (Fatima Cardoso et al, FPN [Final Publication Number] 178P) and is reused with permission from ESMO and all authors.

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Last modified: August 10, 2023

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