Patients’ Estimation of Overall Treatment Burden: Why Not Ask the Obvious?

Bernhard, Jürg; Maibach, Rudolf; Thürlimann, Beat; Sessa, C.; Aapro, Matti

doi:10.1200/jco.2002.20.1.65

Cited by 33 publications

(17 citation statements)

References 38 publications

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“…Gender seemed to be a key antecedent of burden because men and women experienced treatment burden differently. Women experienced more treatment burden than men and also reported more caregiver burden when their children were sick, possibly as a result of their traditional homemaker roles . A strong positive correlation was apparent between unemployment and treatment burden .…”

Section: Resultsmentioning

confidence: 94%

“…Physical side‐effects were a significant source of treatment burden, arising in particular from medications or drug interactions . Side‐effects could occur at any stage of treatment.…”

Section: Resultsmentioning

confidence: 99%

“…Side‐effects varied in nature and severity, from minor hypoglycaemic events and weight gain, to those that are so unpleasant that the possibility of experiencing them frightened some patients . Experiencing more than one side‐effect contributed to overall treatment burden . Some side‐effects may be preventable especially those related to the use of medications that were no longer required …”

Section: Resultsmentioning

confidence: 99%

“…Patients and carers, however, were not homogenous and therefore could have different perceptions concerning the burden related to similar tasks . This subjective aspect of treatment burden was associated with a number of factors and therefore may be predictable. However, as it includes elements of an intangible nature, for example, guilt, hopelessness, and fear, its quantification could be difficult.…”

Section: Resultsmentioning

confidence: 99%

“…Few validated instruments have been developed to assess the experiences of treatment burden on patients . In some cases however, the concept of treatment burden has been included as one domain within a multidimensional instrument designed to assess health‐related quality of life or treatment satisfaction .…”

Section: Introductionmentioning

confidence: 99%

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Section: Resultsmentioning

confidence: 94%

“…Physical side‐effects were a significant source of treatment burden, arising in particular from medications or drug interactions . Side‐effects could occur at any stage of treatment.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Burden of treatment for chronic illness: a concept analysis and review of the literature

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Pertuzumab Plus Trastuzumab With or Without Chemotherapy Followed by Emtansine in ERBB2-Positive Metastatic Breast Cancer

et al. 2023

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ImportanceIn ERBB2 (formerly HER2)-positive metastatic breast cancer (MBC), combining trastuzumab and pertuzumab with taxane-based chemotherapy is the first line of standard care. Given that trastuzumab plus pertuzumab was proven effective in ERBB2-positive MBC, even without chemotherapy, whether the optimal first-line strategy could be trastuzumab plus pertuzumab alone instead of with chemotherapy is unresolved.ObjectiveTo assess overall survival (OS) at 2 years and progression-free survival (PFS) for patients randomly assigned to receive first-line pertuzumab plus trastuzumab alone or with chemotherapy followed by trastuzumab and emtansine at progression; PFS of second-line trastuzumab and emtansine treatment following trastuzumab plus pertuzumab; and OS and PFS in the ERBB2-enriched and ERBB2-nonenriched subtypes.Design, Setting, and ParticipantsThis was a secondary analysis of a multicenter, open-label, phase 2 randomized clinical trial conducted at 27 sites in France, 20 sites in Switzerland, 9 sites in the Netherlands, and 1 site in Germany. Overall, 210 patients with centrally confirmed ERBB2-positive MBC were randomized between May 3, 2013, and January 4, 2016, with termination of the trial May 26, 2020. Data were analyzed from December 18, 2020, to May 10, 2022.InterventionsPatients randomly received pertuzumab (840 mg intravenously [IV], then 420 mg IV every 3 weeks) plus trastuzumab (8 mg/kg IV, then 6 mg/kg IV every 3 weeks) without chemotherapy (group A) or pertuzumab plus trastuzumab (same doses) with either paclitaxel (90 mg/m2 for days 1, 8, and 15, then every 4 weeks for ≥4 months) or vinorelbine tartrate (25 mg/m2 for first administration followed by 30 mg/m2 on days 1 and 8 and every 3 weeks for ≥4 months) followed by pertuzumab plus trastuzumab maintenance after chemotherapy discontinuation (group B).Main Outcomes and MeasuresOverall survival at 24 months by treatment group, PFS for first-line treatment, PFS for second-line treatment, and patient-reported quality of life (QOL).ResultsA total of 210 patients were included in the analysis, with a median age of 58 (range, 26-85) years. For group A, 24-month OS was 79.0% (90% CI, 71.4%-85.4%); for group B, 78.1% (90% CI, 70.4%-84.5%). Median PFS with first-line treatment was 8.4 (95% CI, 7.9-12.0) months in group A and 23.3 (95% CI, 18.9-33.1) months in group B. Unlike expectations, OS and PFS did not markedly differ between populations with ERBB2-enriched and ERBB2-nonenriched cancer. Adverse events were less common without chemotherapy, with small QOL improvements from baseline in group A and stable QOL in group B.Conclusions and RelevanceThe findings of this secondary analysis of a randomized clinical trial suggest that the chemotherapy-free anti-ERBB2 strategy is feasible without being detrimental in terms of OS. The 50-gene prediction analysis of microarray signature could not help to identify the most appropriate patient population for this approach.Trial RegistrationClinicalTrials.gov Identifier: NCT01835236

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Communication about standard treatment options and clinical trials: can we teach doctors new skills to improve patient outcomes?

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Patients’ Estimation of Overall Treatment Burden: Why Not Ask the Obvious?

Cited by 33 publications

References 38 publications

Burden of treatment for chronic illness: a concept analysis and review of the literature

Burden of treatment for chronic illness: a concept analysis and review of the literature

Pertuzumab Plus Trastuzumab With or Without Chemotherapy Followed by Emtansine in ERBB2-Positive Metastatic Breast Cancer

Communication about standard treatment options and clinical trials: can we teach doctors new skills to improve patient outcomes?

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