Abstract P6-09-01: Treatment goals and quality of life (QOL) in a survey of patients with ER+/HER2- metastatic breast cancer (mBC)
Authors: Sammons Sarah L. , Meisel Jane , Shanahan Kelly , Pluard Timothy , Kozlowski Monica , Carroll Dominic , Attias Elizabeth 
Published: March 2023

Abstract
Introduction: In patients (pts) with ER+/HER2- mBC, insights into the foremost concerns regarding their mBC treatment goals and QOL are often assumed by providers but are vastly understudied. The objectives of this survey were to better comprehend treatment goals and QOL concerns in pts with ER+/HER2- mBC. Methods: The 42-question, online EQUALS (ESR1 QUAlity of Life Survey) survey was sent to US subjects in June 2022 from 1) the Cure Media Group (n=6,625) by email, 2) private Facebook groups of pts with mBC and 3) members of a BC clinic. Subjects were eligible if they had ER+/HER2- mBC. A $10 gift card was obtained at survey completion. Survey answers were summarized descriptively. Results: 213 pts completed the survey. Respondents had a mean age of 57 y (range, 31–83 y), and were mostly white (91%), living in an urban/suburban setting (75%), with a higher education degree (71%) and household income ≥$75k (53%). Mean year of mBC diagnosis was 2018 (range, 1995–2022). Most common first-line mBC treatments were aromatase inhibitor (AI) + CDK4/6 inhibitor (CDK4/6i; 44%), AI alone (18%), or fulvestrant + CDK4/6i (16%);54% had received chemotherapy in the metastatic setting. Pts most frequently received information about new mBC treatments from other people living with mBC (42%), followed by physicians (34%), social media (31%), or medical journals/conferences (28%). Two-thirds of pts (64%) reported good/very good QOL, with 12% reporting poor/very poor QOL. Common side effects mostly/moderately impacting QOL were: fatigue (74%), joint pain (64%), vaginal atrophy/dryness (56%), and vasomotor symptoms (47%). Most (84%) were comfortable/very comfortable discussing side effects with their medical team (MT). Worry about disease progression occurred often: everyday (38%), a few times a week (21%) or month (18%), or only before scans (15%). Upon progression, pts worried more about efficacy of new treatment (76%) and having additional options (70%) than they did about side effects (33%). Pts’ current treatment goals were: control cancer growth/spread (93%), prolong life (82%), maintain QOL (81%), tolerate side effects (61%), and relieve suffering/pain (57%); similar to their goals at diagnosis. Almost two-thirds of MTs addressed these goals at the beginning of treatment (63%) and continued annually (60%). Most pts (70%) were very concerned that their mBC diagnosis impacted their family although 81% felt supported at home. Since diagnosis, major/moderate life impacts were: side effects (82%), mental health/stress (78%), QOL (71%), inability to engage in activities (62%), and finances (61%). Most pts (64%) thought their mBC or treatment impacted their intimate/sexual relationship negatively and half (50%) worried about sexual intimacy. Only 44% of pts were comfortable discussing intimacy/sexual side effects with their MT. More pts were comfortable/very comfortable discussing sexual side effects with their MT if their oncologists were female (64%) vs male (51%), BC (73%) vs general (45%), or academic (70%) vs community hospital (52%) or office-based practice (49%). Most (92%) were concerned that their treatments may have a negative impact on their bones. Conclusion: In this survey of pts with ER+/HER2- mBC, &gt;70% received information about new mBC treatments from other pts or social media vs physicians. Pts’ primary concerns were disease control and treatment options, although treatment side effects had the most impact on QOL. Mental health/stress, intimacy and relationships, and bone health were also impacted. Respondents to online surveys in mBC may portray non-representative populations lacking diversity and attempts to diversify future research are much needed, and further efforts are ongoing to address this knowledge gap.
Citation Format: Sarah L. Sammons, Jane Meisel, Kelly Shanahan, Timothy Pluard, Monica Kozlowski, Dominic Carroll, Elizabeth Attias. Treatment goals and quality of life (QOL) in a survey of patients with ER+/HER2- metastatic breast cancer (mBC) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-09-01.