Purpose: Cancer patients with bone metastasis (BM) from solid tumors or multiple myeloma (MM) have an increased risk of painful skeletal-related events (SREs), which can decrease quality of life and increase mortality. Bone targeting agents (BTAs) can help delay or prevent SREs; however, a significant portion of eligible patients are not receiving BTA therapy. This study was conducted to understand patient awareness of cancer-related bone health and to identify opportunities to improve bone health education in cancer patients at risk of SREs. Methods: The online BonE heAlth eduCatiOn Needs assessment (BEACON) survey included questions about patient demographics, cancer diagnosis and treatments (including BTA usage), and extent and satisfaction with bone health education received. Direct-topatient outreach was used to recruit patients. Eligible patients were US adults with a diagnosis of self-reported MM or BM from a solid tumor (breast, lung, or prostate cancer) within the past three years. Results: Of 125 patients, 71% were diagnosed with solid tumors with BM and 29% with MM. At least one prior SRE was experienced by 57% of patients (38% radiation to bone, 32% bone fracture, 22% spinal cord compression, and 19% surgery to bone), and 74% were currently receiving BTA therapy. Awareness of cancer bone health, protection strategies, and screening tests was low to moderate; patients were least informed of the impact of lifestyle changes (38%) and specific cancer treatments (≤35%) on bone health. Sixty-two percent of patients were not completely satisfied with the bone health education received. Patients generally wanted more information (58%) and to receive information by more than one mode of communication. Conclusion:Notable gaps in bone health education were observed in cancer patients at risk for SREs indicating an important need for improved communication and education strategies to promote better health outcomes.
Short-and long-acting G-CSFs are indicated to decrease the incidence of infection as manifested by febrile neutropenia (FN), a severe side effect of myelosuppressive chemotherapy. Objective to estimate breast cancer patients' relative preferences and willingness to pay (WTP) for different G-CSF prophylaxis attributes. Methods: We completed a discrete choice experiment via an online crosssectional survey of self-reported breast cancer patients previously treated with myelosuppressive chemotherapy. Participants were presented 18 G-CSF scenarios with different levels of the following attributes: risk of developing FN requiring hospitalization, risk of disrupting the chemotherapy schedule due to FN, need for additional clinic visits, number of G-CSF administrations, and total out-of-pocket (OOP) G-CSF cost per chemotherapy cycle. Attribute preferences and WTP were measured using hierarchical Bayesian logistic regression. Results: By descending median preference weight, participants (N=302) preferred G-CSF options with the lowest OOP cost (difference between highest and lowest=2.682; 95% CI=2.177-3.311), lowest risk of FN requiring hospitalization (1%:24%; difference=2.352; 95% CI=1.900-2.750), lowest risk of chemotherapy disruption (low:high; differ-ence=1.436; 95% CI=1.162-1.718), lower number of clinic visits (0:11; differ-ence=1.302, 95% CI=0.
PURPOSE Nearly 40% of patients with bone metastases from breast cancer experience a skeletal-related event (SRE) such as fracture, spinal cord compression, bone surgery, or radiation to bone, within 1 year of diagnosis (1). Bone-targeting agents (BTAs) significantly reduce the risk of SREs, but real-world data indicates that only 58% (Commercial) and 67% (Medicare) of eligible metastatic breast cancer patients receive treatment with a BTA (2, 3). We surveyed U.S. patients with bone metastases from breast cancer to ascertain their awareness regarding bone health, to describe the source and amount of bone health education received, and to identify potential gaps in bone health education. METHODS The BonE heAlth eduCatiOn Needs assessment (BEACON) survey was developed through a collaboration between GRYT Health Inc. and Amgen Inc. The online survey consisted of treatment-related questions, cancer-related bone health educational questions, and open-ended questions. U.S. adult patients who consented to participate, with self-reported bone metastasis from breast cancer, were recruited using a unique IRB-approved direct-to-patient approach pioneered by GRYT Health, which incorporates digital outreach, advocacy partnerships, and virtual app and conference-based communication. RESULTS Seventy-four breast cancer patients with bone metastasis completed the online survey. Thirty-eight (51%) had experienced at least one SRE, defined as bone fracture (n=19; 26%), spinal cord compression (n=11; 15%), or radiation (n=28; 38%) or surgery (n=9; 12%) on a bone. While the majority of patients were aware that bones are more fragile in individuals with cancer (n=48; 65%) and that treatments are available to help prevent broken bones caused by cancer (n=50; 68%), fewer understood that bones are more fragile after receiving chemotherapy (n=20; 27%) and radiation (n=28; 38%), or that lifestyle changes can help to prevent broken bones (n=23; 31%). Similarly, when asked about bone protection, the majority of patients had knowledge about calcium and/or vitamin D supplements (n=55; 74%) and BTAs (n=53; 72%), but only 24% had knowledge of lifestyles changes as a bone health protection strategy (n=18). Oncologist and nurses were the most commonly reported HCPs to provide cancer-related bone health information. Patient-reported satisfaction with the amount of bone cancer education was “low” or “moderate” (n=46; 62%); “low” satisfaction was more common in patients not receiving a BTA (n=6/13; 46%) compared to those currently receiving a BTA (n=17/61; 28%). More than half of patients reported receiving either no bone health information (n=8; 11%) or less information than desired (n=35; 47%). CONCLUSION Despite potential limitations in patient recall and population selection biases, there appears to exist important gaps in knowledge and education related to bone health and SRE prevention among metastatic breast cancer patients. Patient- and provider-oriented interventions that increase opportunities for communication and education on bone health may help ensure optimal SRE prevention strategies including appropriate BTA use. REFERENCES 1. Clemons M, Gelmon KA, Pritchard KI, Paterson AH. Curr Oncol 2012 Oct; 19(5):259-268. 2. Hernandez RK, Adhia A, Wade SW, et al. Clin Epidemiol 2015 Jul; 7:335-345. 3. McGrath LJ, Overman RA, Reams D, et al. Clin Epidemiol 2018 Sep; 10:1349-1358. Citation Format: Darcy R Flora, Katherine B Carlson, Kimberly Lowe, Benoit Cadieux, Guy Boike, Basia Bachmann, David C Fuehrer. Findings from the BonE heAlth eduCatiOn needs assessment (BEACON) study: A survey of bone metastatic breast cancer patients at risk for skeletal-related events [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 PS9-69.
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