64P - Unmet needs following metastatic breast cancer in a middle-income Asian country

Background

The burden of metastatic breast cancer (mBC) is high in many low-middle income countries. Given the wider social and economic implications associated with advanced cancer, understanding the unmet needs of patients with mBC is crucial towards the design and provision of tailored supportive care. We aimed to determine the unmet needs of women newly diagnosed with mBC in a middle-income Asian setting with limited cancer survivorship services.

Methods

Women who were diagnosed with mBC in the 12 months preceding the study were recruited from a Ministry of Health hospital, an academic hospital, and two private hospitals in Malaysia, an upper-middle income Asian country. Unmet needs were assessed using the Needs Assessment Tool for Breast Cancer (NeAT-BC), a 48-item dual language questionnaire that we had previously developed and validated in the local setting.

Results

In this interim analysis with 96 participants, 74% of women indicated having at least one unmet need. The highest unmet needs were reported for the hospital appointments domain (79.2%) as well as the information and services domain (80.2%). Besides the need for shorter waiting times in the hospital (88.5%), many women also described having unmet needs regarding information on daily aspects of living including on diet (79.2%) and self-care (78.1%). Finance-wise, 62.5% reported needing help to pay for their cancer therapies, while 59.4% expressed an unmet need for affordable transportation options to the hospital. In this setting with strong sociocultural beliefs on traditional and complementary therapies (TCM), 53.1% of women with mBC reported an unmet need for open discussions with their healthcare providers on the use of TCM. No significant differences in the overall level of unmet needs were observed by age, ethnicity, hospital type, education level, and ownership of health insurance (p>0.05).

Conclusions

A high burden of unmet needs were observed among women with mBC in this middle-income Asian setting with limited supportive care services. In resource-limited settings, routine assessment of unmet needs as well as presence of dedicated personnel to navigate access to supportive services may play a key role in alleviating these needs.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

University Malaya.

Funding

Novartis Corporation (M) Sdn Bhd.

Disclosure

N. Bhoo-Pathy: Financial Interests, Personal and Institutional, Research Funding: Novartis, Zuellig Pharma; Financial Interests, Personal, Other, Honorarium: Novartis, Pfizer, Roche; Non-Financial Interests, Personal and Institutional, Other, Research equipment: Roche Diagnostics. M. Thiagarajan: Non-Financial Interests, Personal and Institutional, Advisory Role: Jannsen, Astellas, MSD, Pfizer, Novartis; Financial Interests, Personal and Institutional, Research Funding: Novartis, MSD, Jannsen, Roche. N.F. Bt Abdul Satar: Financial Interests, Personal, Other, Honoraria: Roche, MSD Malaysia, Eisai, Ipsen Pharma; Financial Interests, Personal, Other, Honorarium: Pfizer, Zuellig Pharma; Financial Interests, Personal and Institutional, Research Funding, PI Clinical Trial: MSD Malaysia, Naluri Sdn Bhd, Viracta Therapeutics, KURA Oncology; Non-Financial Interests, Personal, Project Lead: Cancer ECHO UM. M. Md Yusof: Financial Interests, Institutional, Advisory Board, disease and treatment indications advisory board or expert committee meeting, as panellist or chair or speaker: AstraZeneca, Specialsed Therapeutics, Roche, MSD, Pfizer, Novartis, Eli Lily, Eisai; Financial Interests, Institutional, Invited Speaker, disease and treatment indications -speaker: Amgen; Financial Interests, Institutional, Invited Speaker, invited speaker for local conferences: Zuellig Pharma; Financial Interests, Institutional, Invited Speaker, speaker: Mundi Pharma, GSK; Financial Interests, Institutional, Other, speaker for doctors only platform webinar: Docquity; Financial Interests, Personal, Advisory Board, advisory board member for amivantamab in exon 20 insertion tve cancer: Johnson and Johnson; Financial Interests, Personal, Ownership Interest, surgery and oncology centre small partnership: Integrated Oncology Centre ( Kuala Lumpur) Sdn Bhd; Financial Interests, Personal and Institutional, Local PI, KEYNOTE 119, KEYNOTE 355, KEYNOTE B49, KEYNOTE4280A, KEYNOTE 076: MSD; Financial Interests, Personal and Institutional, Funding, local funding for multicentre data collection and reporting: Mundi Pharma; Financial Interests, Personal and Institutional, Local PI, Compleement1, EPIKB3, CANOPY-A: Novartis; Financial Interests, Personal and Institutional, Local PI, CAPITELLO, L-MOCA, ADAURA-A, SERENA-4: AstraZeneca; Financial Interests, Personal and Institutional, Local PI, GLOW study: Astellas; Financial Interests, Personal and Institutional, Local PI, ARc -10 study: ARCUS 10; Non-Financial Interests, Personal, Leadership Role, secretary: Malaysian Oncological Society; Non-Financial Interests, Personal, Advisory Role, clinician advisor: Breast Cancer women association ( NGO), KANWORK ( NGO); Non-Financial Interests, Personal, Advisory Role, government led group to evaluate the cost effectiveness of neoadjuvant anti HER2 therapy: Health Technology Assessment Trastuzumab in neoadjuvant treatment early breast cancer; Non-Financial Interests, Personal, Advisory Role, Clinical Practice Guideline for Breast Cancer 2020-2021: Ministry of Health Malaysia; Non-Financial Interests, Personal, Advisory Role, Specialty Education Subcommittee: Malaysian Medical Council Malaysia; Non-Financial Interests, Personal, Principal Investigator, PALOMA-3 trial: Johnson and Johnson. R. Kaur: Financial Interests, Personal, Other, Honoraria for consultancy and advisory role: Roche, Pfizer, Novartis, AstraZeneca. All other authors have declared no conflicts of interest.