Standardized patient coaching improves therapy persistence in patients with hormone receptor–positive, HER2–negative advanced/metastatic breast cancer treated with abemaciclib

IF 5.2 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI:10.1016/j.breast.2025.104684

Manfred Welslau , Peter A. Fasching , Nicole Semmler-Lins , Lothar Mueller , Erik Belleville , Lorenz Rieger , Sabrina Uhrig , Mark-Oliver Zahn , Benno Lex , Christoph Uleer , Natalija Deuerling , Tobias Hesse , Dagmar Langanke , Lothar Häberle , Hans Tesch

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引用次数: 0

Abstract

Introduction

Therapy adherence is critical, particularly for patients with breast cancer undergoing oral endocrine therapies. The use of combination regimes, such as CDK4/6 inhibitors, has introduced additional side effects, which can affect adherence. A structured patient coaching and communication tool may positively affect therapy adherence.

Methods

The IMPACT study (NCT04030728) was a randomized trial including patients with advanced breast cancer (aBC) receiving abemaciclib as part of routine clinical care. The study examined the influence of structured coaching on patient adherence. Participants were randomized to receive therapy management incorporating the Multinational Association of Supportive Care in Cancer (MASCC) Oral Agent Teaching Tool (MOATT©) or local standard of care practice (LSOC). The primary endpoint was the persistence rate at week 24 (PR24). Secondary endpoints included time to therapy discontinuation (TTD) and quality of life.

Results

A total of 201 patients were randomized and initiated abemaciclib therapy. By week 24, 22 (10.9 %) patients had permanently discontinued abemaciclib for reasons other than progression or death: 14 (14.1 %) in the LSOC arm and 8 (7.8 %) in the MOATT© arm. PR24 was 68.9 % (95 % CI: 58.3–78.2) in the LSOC arm and 81.6 % (95 % CI: 72.5–88.7) in the MOATT© arm, yielding an odds ratio of 2.01 (95 % CI: 1.02–3.96; P = 0.04). TTD showed a hazard ratio of 0.59 (95 % CI: 0.32–1.07), favoring the MOATT© arm. No significant differences in quality of life between study arms were observed.

Conclusion

Individual patient coaching based on MOATT© demonstrated improved PR24 for patients undergoing abemaciclib treatment for aBC.

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标准化的患者指导提高了接受abemaciclib治疗的激素受体阳性、her2阴性的晚期/转移性乳腺癌患者的治疗持久性

治疗依从性至关重要，特别是对接受口服内分泌治疗的乳腺癌患者。使用联合方案，如CDK4/6抑制剂，已经引入了额外的副作用，这可能会影响依从性。结构化的患者指导和沟通工具可能对治疗依从性产生积极影响。IMPACT研究（NCT04030728）是一项随机试验，纳入了接受abemaciclib作为常规临床护理一部分的晚期乳腺癌（aBC）患者。该研究考察了结构化指导对患者依从性的影响。参与者被随机分配接受治疗管理，包括多国癌症支持治疗协会（MASCC）口服药物教学工具（MOATT©）或当地护理实践标准（LSOC）。主要终点是第24周的持续率（PR24）。次要终点包括治疗停止时间（TTD）和生活质量。结果201例患者随机接受阿贝马昔单抗治疗。到第24周，22例（10.9%）患者因进展或死亡以外的原因永久停药：LSOC组14例（14.1%），MOATT©组8例（7.8%）。LSOC组PR24为68.9% (95% CI: 58.3-78.2)， MOATT©组PR24为81.6% (95% CI: 72.5-88.7)，优势比为2.01 （95% CI: 1.02-3.96; P = 0.04）。TTD的风险比为0.59 (95% CI: 0.32-1.07)，有利于MOATT©组。研究组之间的生活质量没有显著差异。结论基于MOATT©的个体患者指导显示，接受阿贝马昔利布治疗的aBC患者PR24得到改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.