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Enhancing accrual to chemotherapy trials for patients with early stage triple-negative breast cancer: a survey of physicians and patients

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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.

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Authors and Affiliations

  1. Public Health and Preventative Medicine, University of Ottawa School of Epidemiology, Ottawa, Canada

    Carmel Jacobs

  2. Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada

    Carmel Jacobs, Mark Clemons, Mohammed Ibrahim & John Hilton

  3. The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada

    Mark Clemons, Sasha Mazzarello, Lisa Vandermeer, Dean Fergusson & John Hilton

  4. Public Health and Preventative Medicine, University of Ottawa School of Epidemiology, Ottawa, Canada

    Mark Clemons & Brian Hutton

  5. Division of Medical Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada

    Anil A. Joy

  6. London Health Sciences Centre, London, Canada

    Muriel Brackstone

  7. Durham Regional Cancer Centre, Oshawa, Canada

    Orit Freedman

  8. Department of Medicine, University of Ottawa, Ottawa, Canada

    Dean Fergusson

Authors
  1. Carmel Jacobs
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  2. Mark Clemons
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  3. Sasha Mazzarello
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  4. Brian Hutton
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  5. Anil A. Joy
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  6. Muriel Brackstone
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  8. Lisa Vandermeer
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  9. Mohammed Ibrahim
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  10. Dean Fergusson
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  11. John Hilton
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Corresponding author

Correspondence to John Hilton.

Ethics declarations

Local research ethics board approval was obtained from the Ottawa Health Science Network Research Ethics Board for both surveys.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Jacobs, C., Clemons, M., Mazzarello, S. et al. Enhancing accrual to chemotherapy trials for patients with early stage triple-negative breast cancer: a survey of physicians and patients. Support Care Cancer 25, 1881–1886 (2017). https://doi.org/10.1007/s00520-017-3580-4

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  • DOI: https://doi.org/10.1007/s00520-017-3580-4

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