Abstract PS9-07: Metastatic breast cancer patients’ preferences and expectations for oral chemotherapy
Authors: Jaisle Alyssa , Fortune Erica E. , Jacobs Jamie , Saxton Claire , Ackourey Jemeille , Zaleta Alexandra K. 
Published: February 2021

Introduction: As options for cancer treatment continue to expand, there is a growing need to understand patients’ preferences for treatment options and their tolerance for related side effects. The aims of the present analysis were to 1) describe metastatic breast cancer (MBC) patient and survivor perceptions of intravenous (IV) and oral chemotherapy modalities, and 2) explore the relationship between modality perceptions, tolerance for side effects, and current levels of physical and social functioning.

Methods: 129 MBC patients were recruited to participate in an online research survey about expectations and preferences for oral and IV chemotherapy treatments. Respondents were also asked to report their willingness to tolerate various chemotherapy side effects using multi-item Likert scales. Quality of life was assessed using two Patient-Reported Outcomes Measurement Information System (PROMIS-29v2.0) subscales, Physical Function and Ability to Participate in Social Roles and Activities, with transformed T scores used for purposes of interpretation.

Results: Respondents were 91% White and 6% Black with ages ranging from 28 to 77 years old (M= 58.0, SD=10.1). Time since diagnosis ranged from &lt;1 to 32 years (M=11.2, SD=6.4). Almost half of respondents (46%) reported having received both oral and IV chemotherapy at some point during their treatment history, while 36% reported having received only IV and 11% reported having received only oral chemotherapy. When assuming equal effectiveness of the two treatments, the majority of respondents stated a preference for oral chemotherapy (72%) versus IV chemotherapy (11%), while 17% stated no preference. The most frequently expected benefits of oral chemotherapy included ease of managing medication at home (76%), less need to travel to treatment center (81%), and freedom to travel or work while on treatment (73%). The severe (grade III/IV) side effects participants were least willing to tolerate (not at all or not very willing) included hand-foot syndrome (58%), diarrhea (58%), neuropathy (61%), and nausea (57%).

Controlling for treatment history, participants who indicated a preference for oral chemotherapy were more likely to have higher expectations for oral chemo (t=-2.69, p&lt;.01) and better physical (t=-2.06, p&lt;.05) and social functioning (t=-2.27, p&lt;.05). Additionally, they reported less willingness to tolerate key side effects: nausea (t=2.40, p&lt;.05) and neuropathy (t=2.10, p&lt;.05)

Conclusion: Many MBC patients report a preference for oral chemotherapy and believe it will confer benefits including fewer disruptions to work and life. Those who prefer oral chemotherapy are less willing to tolerate side effects and report better social and physical functioning. As options for treatment continue to expand, it is important to understand the shifting perceptions of available treatments among patients. Patients’ attitudes, beliefs, and behaviors can and do influence treatment decision-making and adherence. Additionally, when patients have a better understanding of the treatments they are being offered, they are more likely to have a proactive role in the treatment decision-making process and are less likely to experience decision regret. Therefore, it is key to not only ensure patients are involved in treatment decision-making, it is imperative to ensure that they are prepared with the tools to engage in shared decision-making.

Citation Format: Alyssa Jaisle, Erica E. Fortune, Jamie Jacobs, Claire Saxton, Jemeille Ackourey, Alexandra K. Zaleta. Metastatic breast cancer patients’ preferences and expectations for oral chemotherapy [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-07.