Abstract 152P
Background
The standard treatment for patients with non-metastatic IBC is trimodal therapy (TMT), which includes neoadjuvant chemotherapy (NAC), modified radical mastectomy (MRM), and post-mastectomy radiation therapy (PMRT). In the US, 29% of patients receive TMT. The management of patients with IBC in LMICs is unknown.
Methods
A questionnaire in English and Spanish was constructed to assess the IBC knowledge and practice of providers in LMICs. It was emailed to the ONCOLLEGE group and other oncology providers in LMICs using snowball sampling.
Results
574 providers were emailed the survey. Between June and December of 2023, 145 participants completed the questionnaire, of which 114 from 36 LMICs were included in this analysis (described in the table). The response rate was 25%. 47.2% and 26.8% were very comfortable in treating BC, and IBC, respectively. 74.1% noted that IBC is a clinical diagnosis, though 51.8% stated that pathologic evidence of lymphatic emboli was required for IBC diagnosis. All the providers reported that standard chemotherapy and MRM were available in their practice; 4.5% responded that radiation therapy was not available. 30.7% of the providers responded that more than 90% of their patients undergo all three parts of TMT. 76% reported they would offer TMT in a case-based question in this IBC-specific questionnaire. Patient-level data to confirm these numbers are unavailable. Table: 152P
| n=114 – n (%) | |
| Countries East Asia and the PacificEurope and Central AsiaLatin America and the CaribbeanMiddle East and North AfricaSouth AsiaSub-Saharan Africa | 7 (6.1)6 (5.3)38 (33.3) 30 (26.3)24 (21)9 (7.9) |
| Groups Low incomeLower-Middle incomeUpper-Middle incomeUnclassifiable | 4 (3.5)47 (41.2)47 (41.2)16 (14) |
| Provider Medical oncologySurgical oncologyRadiation oncologyGynecologist Other | 82 (71.9)17 (14.9)19 (16.8)2 (1.8)3 (2.6) |
| Practice General oncologistBreast cancer Breast cancer and 1-2 other cancersOther | 82 (71.9)13 (11.6)16 (14)1 (0.9) |
| Tumor boardYes | 77 (68.8) |
Conclusions
Many patients with IBC in LMICs are not receiving TMT, similar to what has been reported in the US. Most participants had access to TMT, and barriers to diagnosis and treatment were primarily related to lower provider comfort and knowledge; cost and logistical barriers may also have an impact. The next steps will be to create educational material in various languages to improve the knowledge and comfort levels of providers in LMICs as well as in high-income countries.
Legal entity responsible for the study
Protocol approved by the Tufts Medical Center IRB.
Funding
Has not received any funding.
Disclosure
C.G. Lengyel: Financial Interests, Personal, Full or part-time Employment, Employee of Bristol Myers Squibb: Bristol Myers Squibb; Financial Interests, Personal, Stocks/Shares, Stock ownership: Bristol Myers Squibb. A.O. Odhiambo: Financial Interests, Personal, Other, Honoraria: AZ, MSD oncology, Beacon Medicare, Roche; Financial Interests, Personal, Advisory Board: MSD oncology; Financial Interests, Personal, Other, Travel, Accommodations, Expenses: Beacon Medicine. J.P. Leone: Financial Interests, Institutional, Research Grant: Kazia Therapeutics and Lilly; Financial Interests, Personal, Other, Consulting: Minerva Biotechnologies. G. Curigliano: Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, Daiichi Sankyo, Novartis, Pfizer, Pfizer; Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, Daiichi Sankyo, Lilly, Pfizer, Veracyte, BMS, Merck, Exact Sciences, Celcuity; Financial Interests, Personal, Advisory Board, Advisory Board: Menarini, Gilead; Financial Interests, Personal, Other, Advisory Board: Ellipsis; Financial Interests, Institutional, Research Grant, Investigator Initiated Trial: Merck; Financial Interests, Institutional, Funding, Phase I studies: BMS, Novartis, AstraZeneca, Daiichi Sankyo, Roche, Blueprint Medicine, Kymab, Astellas, Sanofi, Philogen; Financial Interests, Institutional, Invited Speaker, Phase I clinical basket trial: Relay Therapeutics; Non-Financial Interests, Officer, Italian National Health Council as Advisor for Ministry of Health: Consiglio Superiore di Sanità; Non-Financial Interests, Advisory Role, Member of the Scientific Council. Patient advocacy association: Europa Donna; Non-Financial Interests, Advisory Role, Cancer Research Foundation: Fondazione Beretta; Non-Financial Interests, Member of Board of Directors, No compensation for this role. This a public national company for cancer prevention: Lega Italiana Lotta ai Tumori; Non-Financial Interests, Officer, Member of the Advisory Council: EUSOMA; Non-Financial Interests, Officer, ESMO Clinical Practice Guidelines Chair: ESMO; Non-Financial Interests, Member of Board of Directors, Chair of Clinical Practice Guidelines Committee: ESMO. S.M. Tolaney: Financial Interests, Personal, Advisory Board, Ad board participant/consultant: ARC Therapeutics, Daiichi Sankyo, Eisai, Genentech/Roche, Gilead, Novartis, Sanofi, Seagen; Financial Interests, Personal, Other, Consulting: Aadi BioPharma; Financial Interests, Personal, Advisory Board, Ad board participation: Artios, Incyte Corp, BeyondSprings; Financial Interests, Personal, Advisory Board, Ad Board Participant/Consultant: AstraZeneca, Eli Lilly; Financial Interests, Personal, Advisory Board, Advisory Board participation: Bayer, Infinity Therapeutics, Myovant, OncXerna, Umoja Biopharma, Zentalis, Zetagen, Natera; Financial Interests, Personal, Other, Consultant: Blueprint Medicines; Financial Interests, Personal, Advisory Board, Ad board participant: Bristol Myers Squibb, Mersana Therapeutics; Financial Interests, Personal, Other, Steering Committee Member/Consultant: CytomX; Financial Interests, Personal, Advisory Board, Advisory Board participation/consulting: Menarini/Stemline; Financial Interests, Personal, Advisory Board, Ad Board participant/consultant: Merck; Financial Interests, Personal, Advisory Board, Ad board participant/Consultant: Pfizer; Financial Interests, Personal, Advisory Board, Advisory board participation: Reveal Genomics; Financial Interests, Personal, Advisory Board, Advisory Board Participation: Zymeworks; Financial Interests, Personal, Advisory Board, Advisory board/consulting: Jazz Pharma; Financial Interests, Institutional, Funding, And steering committing: AstraZeneca; Financial Interests, Institutional, Funding, And steering committee: Eli Lilly; Financial Interests, Institutional, Funding: Pfizer, Sanofi, Seagen, Odonate, Cyclacel, Exelixis, Bristol Myers Squibb, Eisai, Merck, Novartis; Financial Interests, Personal and Institutional, Invited Speaker: CytomX; Financial Interests, Institutional, Funding, and steering committee: Gilead, Genentech/Roche; Financial Interests, Institutional, Invited Speaker: Stemline/Menarini. F. Lynce: Financial Interests, Personal, Other, consulting honorarium: Daiichi Sankyo, AstraZeneca, Pfizer, Eli Lilly; Financial Interests, Institutional, Research Grant: AstraZeneca, Zentalis, Merck, CytomX, Eisai, Incyte and Genentech. D. Trapani: Other, EMA Healthcare Professional Working Party (HCPWP), member: European Medicines Agency (EMA); Other, EML Cancer Medicines Working Group (CMWG), member: World Health Organization (WHO); Other, Strategic Advisory Group of Experts on In Vitro Diagnostics (SAGE IVD), chair: World Health Organization (WHO). All other authors have declared no conflicts of interest.