The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Periodic patient–physician discussions to assess the physical attributes and circumstances of patients with metastatic breast cancer (mBC), a treatable but not curable disease, may help determine the optimal dosages for treatment initiation and following, and most patients would be receptive to having these discussions. These findings were reported at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.

Most patients with mBC remain on treatment indefinitely and undergo multiple lines of therapy. Each new treatment begins with the recommended starting dose (RSD), based on the results of clinical trials and approval by the U.S. Food and Drug Administration (FDA). However, real-world patients’ ability to tolerate the RSD may differ from that of those selected to participate in clinical trials.

Although patient-reported outcomes are recognized, evaluations of patients’ perspectives on drug tolerability and their willingness to discuss individualized doses are lacking. Therefore, the Patient-Centered Dosing Initiative sought to determine the prevalence, impact, and management of treatment-related adverse effects; quality of patient-physician communication regarding adverse effects; and patient interest in discussing alternative approaches to the RSD when adverse effects are experienced or a new treatment is initiated.

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The study was conducted via a confidential online survey that was developed by patient advocates and medical oncologists. Participants were recruited through social media groups, organizational newsletters, and online support forums. Within 15 days, 1221 patients with mBC had completed the survey. These patients had received a median of 2.5 lines of therapy (range, 1 to ≥5), and 564 (46%) of the patients had received their diagnosis within 2 years of taking the survey.

Survey responses indicated that 86% (1051) of patients reported experiencing at least 1 significant treatment-related adverse effect, of whom 20% (213) visited the emergency department/hospital and 43% (454) missed at least 1 treatment. Among those reporting adverse effects, 98% (1026) discussed them with their oncologists, and 82% (838) reported receiving help. The most common mitigation strategies were dosage reductions (66%, n=556) and prescription medications (59%, n=494).

Of the 556 patients treated with dosage reductions, 83% (459) reported feeling better. A significant 92% (1127) of patients expressed a willingness to discuss alternative dosing options based on their personal characteristics and individual preferences.

“Given that 86% of patients with [mBC] experienced at least 1 significant treatment-related adverse effect and 83% reported improvement dosage reduction, innovative dosage-related strategies are warranted to sustain [quality of life],” the study authors concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.


Loeser AL, Peppercorn JM, Burkard ME, Kalinsky K, Rugo HS, Bardia A. Treatment-related side effects and views about dosage assessment to sustain quality of life: results of an advocate-led survey of patients with metastatic breast cancer (MBC). J Clin Oncol. 2021;39:(suppl 15; abstr 1005). doi:10.1200/JCO.2021.39.15_suppl.1005