Supporting patients with metastatic breast cancer during therapy with cyclin-dependent kinase 4/6 (CDK) inhibitors: A needs assessment.
Bibliographic record
Abstract
e13054 Background: Combination therapy with cyclin dependent kinase 4 and 6 inhibitors (CDK4/6i: palbociclib, ribociclib and abemaciclib) and endocrine therapy (ET) has markedly improved treatment of hormone receptor positive (HR+), HER2-negative (-) advanced or metastatic breast cancer (MBC) worldwide.However, data is limited on why patients may discontinue CDK4/6i based therapy and how healthcare providers (HCPs) see their role in educating patients (Px) about side effects and supporting compliance. Objective: This study identifies reasons for suboptimal compliance and early discontinuation of CDK4/6i in US HR+ HER2- MBC Px, with a focus on HCPs and Px educational needs related to on-treatment monitoring, side effects and symptom management. Methods: A sequential mixed-methods design was used; 45-minute phone interviews (n=25) informed the development of an online survey (n=193). Both phases included HCPs comprising medical oncologists (ONCs), oncology registered nurses (RNs), nurse practitioners, and physician assistants (NPs/PAs) in community-based settings. Results: Identified areas of improvement for HCPs included: suboptimal competencies were identified: educating Px adequately regarding potential side effects and engaging them to monitor, report, and address them. Among HCPs surveyed, 26%-48% reported suboptimal knowledge of side effects of specific CDK4/6i [Table]. Interviewees noted that educating Px and setting expectations on potential side effects was critical, but 52% of ONCs reported suboptimal skill doing so. A majority of HCPs (68%-91%) expect Px to be able to report all side effects, with half of ONCs considering compliance with medication entirely Pxs’ responsibility, compared with NPs/PAs and RNs at 16-17%. Conclusions: This study identified areas where HCPs can improve their ability to counsel Px and address concerns that may influence a Px’s decision to prematurely discontinue therapy and should be used to inform future professional development initiatives. [Table: see text]
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".