Disease landscape of advanced HER2-breast cancer patients by treatment line in three EU countries and USA.

Aim: To report treatment patterns and quality of life (QoL) in HER2-negative advanced breast cancer patients. Methods: Data were drawn from a cross-sectional survey in Europe and USA. Results: Hormone plus targeted therapy was the most frequent first-line (1L, 62%) and second-line (2L, 45%) treatment for HR+/HER2-patients. Chemotherapy was most frequent at third-line or greater (3L+, 39%) for HR+/HER2- patients, 2L (51%) and 3L+ (48%) for triple negative breast cancer (TNBC) patients. Time to progression was 13.8 (2L) and 11.0 (3L+) months for HR+/HER2- patients. No comparisons were observed for TNBC patients. EQ-5D-5L scores were highest in patients at 1L and lowest at 3L+. Conclusion: Reduced QoL and treatment response were reported in patients at later lines of therapy.

Breast cancer is the most common cancer in women. Differences in survival are seen depending on how widespread or advanced the cancer is, how many different treatments the patient has been given, as well as whether certain receptors on the tumor are present or absent. Many new treatments are available which can target these receptors. These treatments have improved survival in patients with advanced breast cancer, but other benefits for the patient are not always clear. In addition, differences between countries are possible as official guidance can vary. This study aimed to understand these issues, by asking physicians and their patients across Europe and USA for their views on quality of life and satisfaction with their treatments. We found that, in general, physicians prescribed treatments as recommended in the treatment guidelines. As breast cancer progressed and treatment stopped working, patients were switched on to different treatments. Survival, quality of life and treatment satisfaction were all worse in patients who had switched treatments. It appears that the patients lose confidence that their new treatment will work to improve their quality of life. We also saw differences in some of these outcomes between Europe and USA, which were likely due to differences in the treatment guidelines between countries. Both quality of life and treatment satisfaction are important for the well-being of patients with advanced breast cancer as they now live longer with these new treatments. This should be considered by physicians and taken into account for future work.

Drivers of physician decision-making and patient perspectives across lines of therapy in multiple myeloma in the USA.

Aim: To explore treatment selection for relapsed/refractory multiple myeloma (RRMM), which remains complex due to heterogeneity of available treatments and lack of defined standard of care. Patients & methods: The Adelphi Real World MM Disease Specific Programme surveyed physicians in the USA and their patients with MM to collect real-world data on patterns and perceptions of MM treatment across lines of therapy (LOT). Results: Triplets were the most common regimens across each LOT. Physicians reported efficacy-related factors, health insurance coverage, and clinical guidelines as key determinants of treatment choice regardless of LOT. Patients identified better quality of life as the most important treatment benefit. Conclusion: The DSP RW data highlight drivers of RRMM treatment choice from physicians' and patients' perspectives and need for a more holistic approach to guidelines and clinical trials that encompasses patient perspectives.

Multiple myeloma (MM) is an incurable cancer of white blood cells. Treatments tend to become less effective when taken for long periods of time, meaning that patients often receive several different treatments over the course of their disease. Many different drugs and drug combinations are now available for patients with MM. As there is no standardized approach for the treatment of MM, it can be challenging for physicians to choose between the various complex treatment options for their patients, and the key factors that influence physicians' treatment choices remain unclear. In this study, we used information from a survey of physicians and their patients with MM in the USA to investigate which treatments were used most commonly and how physicians and patients made decisions about their treatment. We found that patients with MM were typically treated with a combination of three drugs which differed between patients. When deciding which treatment to prescribe to their patients, physicians primarily considered factors related to how well a treatment works and, in-turn, prolong a patient's life, but this was also considered by physicians to be an area for improvement. While patients also favored treatments associated with a longer life, they more commonly favored those associated with a better quality of life. These findings show that quality of life is important to patients receiving treatment for MM and should be taken into account by physicians when choosing a treatment for their patients.

Real-world treatment patterns, healthcare resource use and disease burden in patients with multiple myeloma in Europe.

Aim: To investigate treatment patterns, healthcare resource utilization and disease burden in patients with multiple myeloma (MM). Methods: Point-in-time survey of physicians and their patients presenting in a real-world clinical setting, collected across Europe between May and November 2021. Results: In total, 173 physicians provided data for 2179 patients with MM. Treatments received became more diverse as line of therapy increased, dictated by previous treatment choices. Overall, 25% of all patients were tri-exposed, and experienced a higher degree of healthcare resource utilization, disease burden and impairment than non-tri-exposed patients. Conclusion: The treatment landscape in MM is complex and evolving. There is an unmet need for more effective therapies to reduce disease burden, particularly in tri-exposed patients.

There are many new treatments available for patients with multiple myeloma. While outcomes such as survival, symptoms and health problems experienced have improved, patients still continue to relapse and fall ill again. This means their current treatment stops working and they have to change to a new treatment to prevent their disease from developing further. Patients who have received three different types of treatment are classed as being 'tri-exposed', and they experience greater problems with their health. To better understand this course of events, we used information from a survey of doctors and their patients with multiple myeloma across Europe in 2021. We looked at patient's symptoms, the treatments they received, how and when they accessed healthcare (including hospital visits and tests) and the overall difficulties experienced due to their illness. We found that patients were broadly treated according to the most recent European guidelines, although differences were seen between countries. When patients had to switch therapy, the type of treatment received next depended on what they had previously been prescribed, meaning that treatment choices became increasingly complicated. Overall, 25% of patients in our study were classed as tri-exposed, and had more hospitalisations, required more hospital tests, had greater health problems and experienced more difficulties at work than those who were not tri-exposed. Despite recent developments in the treatment of multiple myeloma, there is still a need for more effective therapies. This is especially true for patients who are tri-exposed, who have limited treatment options and experienced greater health problems.

Real-world patient-reported outcomes and concordance between patient and physician reporting of side effects across lines of therapy in multiple myeloma within the USA.

PURPOSE: We aimed to explore patient-reported outcomes (PROs) and patient and physician concordance of side effects perception across lines of therapy (LOT) in multiple myeloma (MM) within the United States of America (USA). METHODS: Data were drawn from the Adelphi Real World MM III Disease Specific Programme™, a point-in-time survey of hemato-oncologists/hematologists and their patients with MM conducted in the USA between August 2020 and July 2021. Physicians reported patient characteristics and side effects. Patients reported side-effect bother and health-related quality of life (HRQoL) using validated PRO tools (European Organisation for the Research and Treatment of Cancer Quality of Life Core Questionnaire/-MM Module [EORTC QLQ-C30/-MY20], EQ-5D-3L and Functional Assessment of Cancer Therapy-General Population physical item 5). Descriptive, linear regression and concordance analyses were performed. RESULTS: Records from 63 physicians and 132 patients with MM were analyzed. EORTC QLQ-C30/-MY20 and EQ-5D-3L scores were consistent across LOTs. Scores tended to be worse with higher side-effect bother; patients "very much" bothered by side effects had lower median (interquartile range) global health status scores (33.3 [25.0-50.0]) than those "not at all" bothered (79.2 [66.7-83.3]). Patient and physician concordance on side-effect reporting was poor to fair. Patients frequently reported fatigue and nausea as bothersome side effects. CONCLUSION: HRQoL of patients with MM was worse with greater side-effect bother. Discordant patient and physician reporting of side effects indicated a need for improved communication during management of MM.