Patient-centred care can improve disease-related outcomes and quality-of-life (QoL), but studies gauging patient preferences in early breast cancer (eBC) are limited. This study aimed at identifying preferences of patients (pts) with high-risk hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) eBC related to adjuvant endocrine treatment (ET) characteristics.
Women with HR+/HER2- eBC with high-risk of relapse (defined by (neo)adjuvant chemotherapy pre-treatment) who were prescribed ET and diagnosed between 2009-2021 were recruited in Germany. Patient-relevant attributes for ET were identified by a stepwise multimodal approach [desk research, qualitative interviews (20 pts, 5 caregivers, and 12 physicians), quantitative survey (85 pts: 79 on ET, 6 planned), and cross-functional review]. A conjoint matrix was developed consisting of one attribute for ET goal (30% reduced risk of relapse), 4 attributes for QoL, and 5 attributes for side effects (Table), forming the basis of a subsequent adaptive choice-based conjoint survey.
In the quantitative study, pts aged 49.4 years (mean) were included; among which 69.4% were still working. Relative assessment of ET attributes against each other revealed that achieving ET goal had the highest relevance, while avoiding side effects and maintaining QoL were less relevant. Most pts rated side effect avoidance, particularly diarrhoea, arthralgia, and nausea as the least relevant criterion for ET decision. Overall, 34.6% of pts have considered stopping ET while 6.4% have taken ≥ 1 break due to side effects.
ET goal attainment (30% reduced risk of relapse) was of greatest relative relevance to pts while side effect avoidance and QoL maintenance were less relevant highlighting the impact of relapse risk reduction on ET decisions in high-risk eBC. ET attributes employed in the conjoint analysis
ET attribute Factors Risk of tumour recurring in some way ET goal Physical fitness and agility QoL Mental/emotional stability QoL Maintaining ability to work QoL Participation in family life & leisure QoL Diarrhea Side effects Fatigue Side effects Arthralgia Side effects Loss of hair Side effects Nausea Side effects
Dr. Catherine Sirafim, an employee of Eli Lilly and Company, provided editorial assistance for this abstract.
Eli Lilly and Company.
Eli Lilly and Company.
A. Wöckel: Financial Interests, Personal, Other, Consulting honorarium: Amgen, AstraZeneca, Celgene, Eisai, Lilly, Novartis, Pfizer, Roche, Tesaro, Sirtex, MSD, Genomic Health, Pierre Fabre, Clovis, Organon, Seagen, Exact Sciences, Gilead, Dajiichi Sanko; Financial Interests, Personal, Invited Speaker: Amgen, AstraZeneca, Celgene, Eisai, Lilly, Novartis, Pfizer, Roche, Tesaro, Sirtex, MSD, Genomic Health, Pierre Fabre, Clovis, Organon, Seagen, Exact Sciences, Gilead, Dajiichi Sanko; Financial Interests, Personal, Other, Support for advanced trainings: Amgen, AstraZeneca, Celgene, Eisai, Lilly, Novartis, Pfizer, Roche, Tesaro, Sirtex, MSD, Genomic Health, Pierre Fabre, Clovis, Organon, Seagen, Exact Sciences, Gilead, Dajiichi Sanko. T. Park-Simon: Financial Interests, Personal and Institutional, Invited Speaker: Roche, GSK, AstraZeneca, Pfizer, Lilly, Daiichi-Synkyo, Seagen, Gilead, Eisai, MSD; Financial Interests, Personal and Institutional, Advisory Board: Roche, GSK, AstraZeneca, Pfizer, Lilly, Daiichi-Synkyo, Seagen, Gilead, Eisai, MSD; Financial Interests, Personal and Institutional, Principal Investigator: Roche, GSK, AstraZeneca, Pfizer, Lilly, Daiichi-Synkyo, Seagen, Gilead, Eisai, MSD. A. Korfel, K. Raab, H. Silberzahn: Financial Interests, Personal, Full or part-time Employment: Eli Lilly; Financial Interests, Personal, Stocks/Shares: Eli Lilly. H. Tesch: Financial Interests, Personal and Institutional, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Pfizer, Seagan, Daiichi, GSK, Exact Science, Vifor, Lilly, AstraZeneca, MSD; Financial Interests, Personal, Ownership Interest: VISION MED GmbH, Care and Coach GmbH, CHOP GmbH; Financial Interests, Personal, Funding: Lilly; Non-Financial Interests, Personal, Member: DGHO, ESMO, ASCO, Deutsche Gesellschaft für Senologie; Financial Interests, Personal, Other, Travel Expenses: GSK, Pfizer; Non-Financial Interests, Personal, Other, Travel Expenses: Deutsche Gesellschaft für Senologie.