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Old 04-09-2010, 09:47 AM   #1
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Patient/Doctor Expectations of Metastatic Breast Cancer Treatments at Odds

Elsevier Global Medical News. 2010 Apr 6, S Freeman

BARCELONA (EGMN) - Nearly half of women with metastatic breast cancer believe that any new treatment they start should increase their chances of survival by at least 1 year, compared with standard therapy. Oncologists have a much lower threshold, according to researchers who queried both groups on what they considered important when deciding on specific treatments.

Survey data presented at the European Breast Cancer Conference showed that 48% of women with metastatic breast cancer expect a new treatment to increase overall survival by at least 12 months, whereas just 4% of clinicians thought this was a reasonable target. Conversely, 48% of physicians but only 4% of patients thought that an increase in overall survival of 4-6 months was acceptable.

"Our data highlight that there are disparities between oncologists and patients in ranking of determined therapeutic end points and in expectations of metastatic breast cancer treatments," said Dr. Amir Sheik-Yousouf, a resident physician at the University of Toronto.

The Canadian survey drew responses from 28 oncologists who specialized in breast cancer and 52 women with metastatic breast cancer. In the first-line setting for metastatic disease, a majority of clinicians and patients thought that overall survival was the most important clinical outcome (52% and 54%, respectively). However, they disagreed on the minimum duration of benefit that should be achieved.

Nearly half of clinicians ranked progression-free survival (48%) as being the most clinically important end point in metastatic breast cancer. None ranked quality of life, risk of recurrence, or pain symptoms as being clinically important in this context, although 36% believed that quality of life was the second most important end point from a patient's perspective.

Only 4% of patients rated controlling tumor growth as the most important therapeutic outcome. They listed quality of life as their second most important clinical end point (23%), followed by lowering the risk of recurrence (17%) and reducing pain symptoms (2%).

Dr. Patricia A. Ganz of the University of California, Los Angeles commented that although more than half of patients and physicians consider overall survival to be the most important end point in accepting therapy for metastatic breast cancer, physicians consider much smaller absolute improvements in overall survival and progression-free survival as significant enough to adopt new therapies.

"For several of the newer targeted agents, progression-free survival has become the primary outcome for regulatory approval in metastatic breast cancer. And if patients do not value this as an end point, then we need to look into this in more detail," said Dr. Ganz, a professor of health services and of medicine at the university.

"When doctors talk to patients about the benefits of new treatments, they are often a little vague about how long those benefits last ... and indeed how many patients actually stand to benefit," said Lesley Fallowfield, Ph.D., professor of psycho-oncology and director of the Cancer Research UK Psychosocial Oncology Group at Brighton (England) and Sussex Medical School. The survey results show that when patients are fully informed about new treatments, their views do not always match those of their treating physician, she noted.

Although it was a small study and in a selected population, this study shows that patients rate quality of life issues as being very important, Dr. Fallowfield added. "In most metastatic breast cancer trials, we don't rate quality of life systematically, so we're not able to provide patients with information [on survival rates associated with a new drug as well as] what the downsides might be."

Dr. Sheik-Yousouf, Dr. Ganz, and Dr. Fallowfield reported no conflicts of interest.

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Old 06-30-2010, 04:58 PM   #2
Join Date: Jun 2010
Location: Deutch
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Patient/Doctor Expectations of Metastatic Breast Cancer Treatments at Odds

I am wondering when did he go INTO the institution...how long had he been in?
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