Abstract 291P
Background
The breast cancer (BC) treatment landscape is evolving with the availability of new anticancer agents such as antibody drug conjugates (ADCs). Based on major antiemetic guidelines, patients (pts) receiving trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG) are considered at high risk of experiencing nausea and vomiting (N&V) and should routinely be given proper antiemetic prophylaxis. A recent survey was conducted with healthcare providers (HCPs) attending the ESMO 2023 Congress to assess their experience with and perceptions of ADCs, including the emetogenicity and their approach to antiemetic prophylaxis.
Methods
At ESMO 2023, HCPs were recruited to complete a short web-based survey. Target participants were those caring for oncology pts with solid tumors and who were at least familiar with ADC treatments. “In target” participants completed the survey on a computer in the exhibit hall.
Results
A total of 443 HCPs were recruited, with 333 deemed eligible (311 oncologists and 22 other HCPs). The majority of participants treated pts with BC (71%), followed by lung cancer (56%); 61% (n = 202) of all HCPs had or were using ADCs in practice (most commonly T-DXd and SG in BC). 66% and 68% of HCPs using T-DXd and SG, respectively, considered them to be highly or moderately emetogenic; however, 32% and 23% of HCPs considered them to be minimally emetogenic in the BC subset. Perception of emetogenicity was lower among non-users than users. N&V were commonly reported as ADC side effects by current/past users of ADCs; 63% of HCPs reported having had pts with N&V at least sometimes in the acute phase (0-24h post-treatment), 64% in the delayed phase (>24-120h) and 42% in the extended delayed phase (days 5-7); 27% of HCPs reported N&V occurring often/always in both the acute and delayed phases. Of the pts treated with ADCs, a 5-HT3 receptor antagonist (RA) + dexamethasone with or without an NK1 RA was the most common antiemetic prophylaxis; however, importantly, 37% of pts did not receive prophylaxis.
Conclusions
This survey highlights a gap between scientific data and HCP’s perceptions and emphasizes the need for adequate studies and implementation of guidelines on the optimal use of antiemetic prophylaxis.
Editorial acknowledgement
Editorial/medical writing assistance was provided by Jennifer Vanden Burgt, an independent Medical Affairs consultant, Minneapolis, MN.
Legal entity responsible for the study
Elma Research Ltd.
Funding
Helsinn Healthcare.
Disclosure
G. Bianchini: Financial Interests, Personal, Advisory Board: AstraZeneca, Daiichi Sankyo, Lilly, Novartis, Pfizer, Roche, Amgen, MSD, Chugai, Eisai, Gilead, Seagen, Exact Science, Roche, MSD, Gilead; Financial Interests, Personal, Other, Consultancy: AstraZeneca, Daiichi Sankyo, Roche, MSD, Gilead, Sanofi; Financial Interests, Personal, Invited Speaker: Lilly, Roche, AstraZeneca, Daiichi Sankyo, MSD, Chugai, Eisai, Gilead, Seagen, Neopharm Israel; Financial Interests, Personal, Other, Support for attending meetings and/or travel: Roche, Pfizer, MSD, Chugai, Novartis, Gilead, Daiichi Sankyo; Financial Interests, Personal and Institutional, Invited Speaker: Roche, Novartis, Lilly, AstraZeneca; Financial Interests, Institutional, Invited Speaker: Gilead, Pfizer, Daiichi Sankyo, Lilly, MSD, Novartis; Non-Financial Interests, Leadership Role, Head of Traslational Research: Fondazione Michelangelo. Y.H. Park: Financial Interests, Personal, Advisory Board: AstraZeneca, Pfizer, Roche, Novartis, MSD, Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, Roche, Novartis, MSD, Daiichi Sankyo; Financial Interests, Institutional, Other, Research Grant: AstraZeneca, Pfizer, Roche, MSD; Financial Interests, Institutional, Invited Speaker: Pfizer; Non-Financial Interests, Principal Investigator: AstraZeneca, Pfizer, Novartis, MSD, Lilly, Roche, Daiichi Sankyo. H.S. Rugo: Financial Interests, Personal, Other, Consultancy/advisory support: NAPO, Mylan/Viatris, Daiichi Sankyo, Eisai; Financial Interests, Institutional, Invited Speaker: Novartis, Lilly, Pfizer, OBI Pharma, F. Hoffmann-La Roche AG/Genentech, Inc., Daiichi, AstraZeneca, Gilead Sciences, Inc., Merck; Financial Interests, Institutional, Research Grant: Stemline Therapeutics, Ambryx; Non-Financial Interests, Advisory Role, I advise a number of companies without compensation: various. L. Licata: Financial Interests, Personal, Advisory Board: Lilly, Exact Sciences, AstraZeneca, Italfarmaco, Daiichi Sankyo ; Financial Interests, Personal, Other, Consulting: Helsinn; Financial Interests, Personal, Invited Speaker: Eisai, Gilead, Exact Sciences. H. Iihara: Financial Interests, Institutional, Advisory Board: Taiho Pharmaceutical Co., Ltd., Eisai Co., Ltd.; Financial Interests, Personal, Invited Speaker: Daiichi Sankyo, Ltd., Taiho Pharmaceutical Co., Ltd., AstraZeneca plc, Nippon Kayaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Eli Lilly and Company, Nippon Boehringer Ingelheim Co., Ltd.; Financial Interests, Personal, Other, Invited Speaker and Workshop Facilitator: Chugai Pharmaceutical Co., Ltd.; Financial Interests, Personal, Other, Interviewing and Supervision: Astellas Pharma Co., Ltd.; Financial Interests, Personal, Advisory Board: Taiho Pharmaceutical Co., Ltd.; Financial Interests, Institutional, Research Grant: Taiho Pharmaceutical Co., Ltd., Asahi Kasei Pharma Co., Ltd., Mochida Pharmaceutical Co., Ltd., Daiichi Sankyo, Ltd., Japan Blood Products Organization, Nippon Kayaku Co., Ltd., Chugai Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Nippon Kayaku Co., Ltd. F. Scotté: Financial Interests, Personal, Advisory Board, Meetings: Leo Pharma; Financial Interests, Personal, Invited Speaker, symposia: Amgen, MSD, Thermofisher, BMS, Pfizer, MundiPharma, Tilray; Financial Interests, Personal, Invited Speaker: Pierre Fabre Oncology, Clovis Oncology, Gilead, Grünenthal, Pharmanovia; Financial Interests, Personal, Advisory Board: Viatris-Mylan, Viforpharma, Helsinn, Chugai, Sanofi, Sandoz, GSK; Non-Financial Interests, Other, member of faculty for supportive and palliative care: ESMO; Non-Financial Interests, Member of Board of Directors: MASCC, AFSOS. K. Jordan: Financial Interests, Personal, Advisory Board, Adverse Board / Bisphoshonates: Amgen; Financial Interests, Personal, Invited Speaker, Adverse Event Management: Amgen; Financial Interests, Personal, Invited Speaker, ASCO direct: Art Tempi; Financial Interests, Personal, Invited Speaker, ESMO Today: Art tempi; Financial Interests, Personal, Advisory Board, New drug: AstraZeneca; Financial Interests, Personal, Advisory Board, side effect managment: BD Solution; Financial Interests, Personal, Invited Speaker, NEPA: Helsinn; Financial Interests, Personal, Invited Speaker, ASCO Summary: Hexal, Onkowissen; Financial Interests, Personal, Advisory Board, G-CSF: Hexal/Sandoz; Financial Interests, Personal, Advisory Board, Side effect management: Karyopharma; Financial Interests, Personal, Invited Speaker, Adverse Events Management: MSD, Roche; Financial Interests, Personal, Invited Speaker, Supportive Care: Mundipharma; Financial Interests, Personal, Invited Speaker, Antiemetic Update: Riemser; Financial Interests, Personal, Invited Speaker, Immunoglobulins: Shire (Takeda); Financial Interests, Personal, Invited Speaker: Stemline, Pfizer, Janssen, Aptar, Peer Voice; Financial Interests, Personal, Invited Speaker, Update on Antiemetics: Vifor; Financial Interests, Personal, Invited Speaker, OnkoUpdate: med update GmbH; Financial Interests, Personal, Royalties, Coauthor: Kluwer (UpToDate); Financial Interests, Personal, Royalties, Associate Editor of Annals of Oncology: Elsevier; Financial Interests, Institutional, Invited Speaker, Antiemetic Phase III study, Starts in May 2021: Helsinn; Non-Financial Interests, Member: ASCO, MASCC, DGHO; Non-Financial Interests, Leadership Role, Associate Chair of the Supportive Care Group of the German Cancer Society: AGSMO; Non-Financial Interests, Leadership Role, Associate Chair of the Supportive Care Group: AIO; Non-Financial Interests, Leadership Role, Educational Committee Chair, SE Supportive Care Guideline group: ESMO; Non-Financial Interests, Advisory Role, Advisory and expert activities: Deutsche Krebshilfe, German Cancer aid, Leopoldina, Federal Ministry of Education and Research (BMBF), Hamburger Cancer Society. M.S. Aapro: Financial Interests, Personal, Invited Speaker: Amgen, ViforPharma; Financial Interests, Institutional, Other, Grant to SPCC: BMS, Exact Sciences, Pfizer, Novartis, Roche, AstraZeneca; Financial Interests, Institutional, Invited Speaker, Grant to SPCC: Helsinn; Financial Interests, Institutional, Other, GRANT TO SPCC: Mundipharma, Fresenius Kabi, Daiichi Sankyo; Financial Interests, Personal, Advisory Board: Astellas; Financial Interests, Personal, Member of Board of Directors: SIOG, UICC; Financial Interests, Institutional, Member of Board of Directors: SPCC, ALL CAN; Non-Financial Interests, Advisory Role, Confidentiality agreement: Various companies; Non-Financial Interests, Leadership Role: European Cancer Organisation, SPCC, SIOG; Non-Financial Interests, Member: MASCC, SBOC, ASCO; Other, SAB member: European School of Oncology. All other authors have declared no conflicts of interest.