Standardized patient coaching improves therapy persistence in patients with hormone receptor–positive, HER2–negative advanced/metastatic breast cancer treated with abemaciclib

TL;DR

A patient coaching tool improved treatment persistence in breast cancer patients taking abemaciclib.

Contribution

A structured coaching tool improved therapy persistence in metastatic breast cancer patients.

Findings

22% fewer patients discontinued abemaciclib with coaching compared to standard care.

Coaching improved 24-week persistence rates by 12.7 percentage points.

No significant quality of life differences were observed between groups.

Abstract

Therapy adherence is critical, particularly for patients with breast cancer undergoing oral endocrine therapies. The use of combination regimes, such as CDK4/6 inhibitors, has introduced additional side effects, which can affect adherence. A structured patient coaching and communication tool may positively affect therapy adherence.

The IMPACT study (NCT04030728) was a randomized trial including patients with advanced breast cancer (aBC) receiving abemaciclib as part of routine clinical care. The study examined the influence of structured coaching on patient adherence. Participants were randomized to receive therapy management incorporating the Multinational Association of Supportive Care in Cancer (MASCC) Oral Agent Teaching Tool (MOATT©) or local standard of care practice (LSOC). The primary endpoint was the persistence rate at week 24 (PR24). Secondary endpoints included time to therapy discontinuation (TTD) and quality of life.

A total of 201 patients were randomized and initiated abemaciclib therapy. By week 24, 22 (10.9 %) patients had permanently discontinued abemaciclib for reasons other than progression or death: 14 (14.1 %) in the LSOC arm and 8 (7.8 %) in the MOATT© arm. PR24 was 68.9 % (95 % CI: 58.3–78.2) in the LSOC arm and 81.6 % (95 % CI: 72.5–88.7) in the MOATT© arm, yielding an odds ratio of 2.01 (95 % CI: 1.02–3.96; P = 0.04). TTD showed a hazard ratio of 0.59 (95 % CI: 0.32–1.07), favoring the MOATT© arm. No significant differences in quality of life between study arms were observed.

Individual patient coaching based on MOATT© demonstrated improved PR24 for patients undergoing abemaciclib treatment for aBC.

•Premature therapy discontinuation is a key challenge in breast cancer management.•In the control group, 14.1 % of patients discontinued abemaciclib prematurely.•Individual patient coaching improved 24-week persistence under abemaciclib therapy.

Premature therapy discontinuation is a key challenge in breast cancer management.

In the control group, 14.1 % of patients discontinued abemaciclib prematurely.

Individual patient coaching improved 24-week persistence under abemaciclib therapy.

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