Carmel Jacobs1,2, Mark Clemons2,3,1, Sasha Mazzarello3, Brian Hutton1, Anil A Joy4, Muriel Brackstone5, Orit Freedman6, Lisa Vandermeer3, Mohammed Ibrahim2, Dean Fergusson3,7, John Hilton8,9. 1. Public Health and Preventative Medicine, University of Ottawa School of Epidemiology, Ottawa, Canada. 2. Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada. 3. The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. 4. Division of Medical Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada. 5. London Health Sciences Centre, London, Canada. 6. Durham Regional Cancer Centre, Oshawa, Canada. 7. Department of Medicine, University of Ottawa, Ottawa, Canada. 8. Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada. jfhilton@toh.ca. 9. The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. jfhilton@toh.ca.
Abstract
PURPOSE: The optimal chemotherapy regimen for patients with early stage triple-negative breast cancer (TNBC) remains unknown. The purpose of the study is to survey physicians and breast cancer patients about preferred chemotherapy regimens for early stage TNBC and clinical trial strategies. METHODS: A standardised online questionnaire was developed and circulated to medical oncologists known to treat breast cancer. A separate questionnaire was given to patients who had received chemotherapy for breast cancer. RESULTS: The questionnaire was completed by 41/84 medical oncologists (48.8% response rate) and 74 patients. The most commonly used neoadjuvant and adjuvant chemotherapy regimens for TNBC were dose-dense doxorubicin and cyclophosphamide (AC)-paclitaxel (P), dose-dense AC followed by weekly P and fluorouracil, epirubicin, cyclophosphamide-docetaxel (FEC-D). The majority of medical oncologists (80%) would be willing to enrol patients in trials evaluating the most effective chemotherapy regimen for TNBC. Oncologists favoured a three arm trial design comparing currently available standard of care treatments (36%) and trials of novel or non-standard of care agents 22% (9/41). Sixty percent (41/74) of patients indicated that they would be willing to be enrolled in trials evaluating various adjuvant regimens for TNBC. Both oncologists and patients were interested in novel consent approaches such as using the integrated consent model. CONCLUSION: Optimisation of chemotherapy for TNBC is an important and unmet clinical need. It is apparent that various chemotherapy regimens are used for patients with early stage TNBC. The majority of medical oncologists and patients are interested in entering trials to optimise chemotherapy choices.
PURPOSE: The optimal chemotherapy regimen for patients with early stage triple-negative breast cancer (TNBC) remains unknown. The purpose of the study is to survey physicians and breast cancerpatients about preferred chemotherapy regimens for early stage TNBC and clinical trial strategies. METHODS: A standardised online questionnaire was developed and circulated to medical oncologists known to treat breast cancer. A separate questionnaire was given to patients who had received chemotherapy for breast cancer. RESULTS: The questionnaire was completed by 41/84 medical oncologists (48.8% response rate) and 74 patients. The most commonly used neoadjuvant and adjuvant chemotherapy regimens for TNBC were dose-dense doxorubicin and cyclophosphamide (AC)-paclitaxel (P), dose-dense AC followed by weekly P and fluorouracil, epirubicin, cyclophosphamide-docetaxel (FEC-D). The majority of medical oncologists (80%) would be willing to enrol patients in trials evaluating the most effective chemotherapy regimen for TNBC. Oncologists favoured a three arm trial design comparing currently available standard of care treatments (36%) and trials of novel or non-standard of care agents 22% (9/41). Sixty percent (41/74) of patients indicated that they would be willing to be enrolled in trials evaluating various adjuvant regimens for TNBC. Both oncologists and patients were interested in novel consent approaches such as using the integrated consent model. CONCLUSION: Optimisation of chemotherapy for TNBC is an important and unmet clinical need. It is apparent that various chemotherapy regimens are used for patients with early stage TNBC. The majority of medical oncologists and patients are interested in entering trials to optimise chemotherapy choices.
Entities:
Keywords:
Breast cancer; Chemotherapy; Trial design; Triple negative
Authors: Ricardo Fernandes; Sasha Mazzarello; Carol Stober; Lisa Vandermeer; Shaan Dudani; Mohamed F K Ibrahim; Habeeb Majeed; Kirstin Perdrizet; Risa Shorr; Brian Hutton; Dean Fergusson; Mark Clemons Journal: Breast Cancer Res Treat Date: 2016-10-25 Impact factor: 4.872
Authors: Gunter von Minckwitz; Andreas Schneeweiss; Sibylle Loibl; Christoph Salat; Carsten Denkert; Mahdi Rezai; Jens U Blohmer; Christian Jackisch; Stefan Paepke; Bernd Gerber; Dirk M Zahm; Sherko Kümmel; Holger Eidtmann; Peter Klare; Jens Huober; Serban Costa; Hans Tesch; Claus Hanusch; Jörn Hilfrich; Fariba Khandan; Peter A Fasching; Bruno V Sinn; Knut Engels; Keyur Mehta; Valentina Nekljudova; Michael Untch Journal: Lancet Oncol Date: 2014-04-30 Impact factor: 41.316
Authors: Donald A Berry; Constance Cirrincione; I Craig Henderson; Marc L Citron; Daniel R Budman; Lori J Goldstein; Silvana Martino; Edith A Perez; Hyman B Muss; Larry Norton; Clifford Hudis; Eric P Winer Journal: JAMA Date: 2006-04-12 Impact factor: 56.272
Authors: Nancy U Lin; Ann Vanderplas; Melissa E Hughes; Richard L Theriault; Stephen B Edge; Yu-Ning Wong; Douglas W Blayney; Joyce C Niland; Eric P Winer; Jane C Weeks Journal: Cancer Date: 2012-04-27 Impact factor: 6.860
Authors: Antonio C Wolff; M Elizabeth H Hammond; Jared N Schwartz; Karen L Hagerty; D Craig Allred; Richard J Cote; Mitchell Dowsett; Patrick L Fitzgibbons; Wedad M Hanna; Amy Langer; Lisa M McShane; Soonmyung Paik; Mark D Pegram; Edith A Perez; Michael F Press; Anthony Rhodes; Catharine Sturgeon; Sheila E Taube; Raymond Tubbs; Gail H Vance; Marc van de Vijver; Thomas M Wheeler; Daniel F Hayes Journal: J Clin Oncol Date: 2006-12-11 Impact factor: 44.544
Authors: Brian Hutton; Christina Addison; Sasha Mazzarello; Anil A Joy; Nathaniel Bouganim; Dean Fergusson; Mark Clemons Journal: J Bone Oncol Date: 2013-04-15 Impact factor: 4.072
Authors: Daniel Khalaf; John F Hilton; Mark Clemons; Laurent Azoulay; Hui Yin; Lisa Vandermeer; Susan Dent; Sean Hopkins; Nathaniel Bouganim Journal: Oncol Lett Date: 2014-01-07 Impact factor: 2.967
Authors: N LeVasseur; C Stober; K Daigle; A Robinson; S McDiarmid; S Mazzarello; B Hutton; A Joy; D Fergusson; J Hilton; M McInnes; M Clemons Journal: Curr Oncol Date: 2018-08-14 Impact factor: 3.677
Authors: John Hilton; Lisa Vandermeer; Marta Sienkiewicz; Sasha Mazzarello; Brian Hutton; Carol Stober; Dean Fergusson; Phillip Blanchette; Anil A Joy; A Brianne Bota; Mark Clemons Journal: Support Care Cancer Date: 2018-02-06 Impact factor: 3.603
Authors: John Hilton; Carol Stober; Sasha Mazzarello; Lisa Vandermeer; Dean Fergusson; Brian Hutton; Mark Clemons Journal: PLoS One Date: 2018-07-24 Impact factor: 3.240