Discerning the clinical relevance of biomarkers in early stage breast cancer

Ballinger, Tarah J.; Kassem, Nawal; Shen, Fei; Jiang, Guanglong; Smith, Mary Lou; Railey, Elda; White, Carol; Schneider, Bryan P.

doi:10.1007/s10549-017-4238-0

Cited by 9 publications

(24 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using conjoint analysis techniques may help in identification of trends in general patient preferences over time and detection of relevant shifts in culture. Interestingly, among other recent studies an excellent study by Ballinger et al found patients to tend to favor toxicity concerns over treatment benefit ( 11 , 13 ), while older studies often found survival benefit to be of supreme importance ( 16 , 28 – 30 ). Clinical trials on population level generally focus on survival benefit as the primary endpoint and most critical aspect of therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The tool of conjoint analysis was implemented to assess different attributes that drive individual patient preferences in regard to taxane-based chemotherapies. Generally, the technique of conjoint analysis is widely used in the medical and non-medical field for assessment of preferences and has been demonstrated to offer a valuable tool to elicit patient preferences or utilities for specific treatments ( 11 – 14 ). In regard to medical treatment, conjoint analysis has proven to be useful for preference elicitation mainly in cancer therapy ( 11 , 13 , 15 , 16 ).…”

Section: Methodsmentioning

confidence: 99%

“…Generally, the technique of conjoint analysis is widely used in the medical and non-medical field for assessment of preferences and has been demonstrated to offer a valuable tool to elicit patient preferences or utilities for specific treatments ( 11 – 14 ). In regard to medical treatment, conjoint analysis has proven to be useful for preference elicitation mainly in cancer therapy ( 11 , 13 , 15 , 16 ). By having participants evaluate alternatives and letting them choose between different combinations of attributes, the relative importance of each attribute can be deducted ( 17 ).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Patient Preferences Regarding Chemotherapy in Metastatic Breast Cancer—A Conjoint Analysis for Common Taxanes

et al. 2018

View full text Add to dashboard Cite

Background: The purpose of this investigation was to explore patient perception regarding the importance of efficacy, toxicity, and logistics in the choice of regimen of taxane-based chemotherapy (CHT) for patients with metastatic breast cancer (MBC).Methods: This dual-center study analyzed data of 100 women diagnosed with MBC, who were asked for their preferences regarding chemotherapy by means of conjoint analysis. Included attributes were progression free survival (PFS), application form, time and frequency, need of premedication, risk of alopecia, fatigue, febrile neutropenia, and neuropathy. Furthermore, participants completed a questionnaire about their personal and medical history. Regression analyses were performed to identify factors that influence patient preference in terms of specific treatment choice.Results: Of 8 attributes, severe neutropenia was top priority for the majority of patients, followed by alopecia, neuropathy and PFS. When combining these patient preferences and the results of the questionnaire, patients' age as, well as, relationship status had significant impact on the importance of PFS. Moreover, longer travel time to the treatment center was significantly associated with preferences regarding PFS. Ranking by combination of respective part-worth values demonstrated nab-paclitaxel to be favored over paclitaxel and docetaxel.Conclusion: Side effects of CHT and PFS prove to be critical factors for patients affecting choice of treatment in MBC with severe neutropenia being top priority, followed by alopecia, neuropathy, and PFS. Age, commute time, and relationship status were identified as significant determinants of patient preference. Total utility calculation by combination of part-worth values ranked nab-paclitaxel as the most preferable taxane.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Patient Preferences Regarding Chemotherapy in Metastatic Breast Cancer—A Conjoint Analysis for Common Taxanes

et al. 2018

View full text Add to dashboard Cite

show abstract

“…[6][7][8] In addition, cross-sectional, retrospective studies have surveyed patients at varying time periods after treatment regarding their recall of symptoms during chemotherapy [9][10][11][12] and the persistence of CIPN after treatment. [6][7][8] In addition, cross-sectional, retrospective studies have surveyed patients at varying time periods after treatment regarding their recall of symptoms during chemotherapy [9][10][11][12] and the persistence of CIPN after treatment.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Cancer September 1, 2019 With regard to CIPN in clinical practice, retrospective chart reviews of clinician notes have identified the percentage of patients whose CIPN toxicity warranted dose reduction or treatment discontinuation. [6][7][8] In addition, cross-sectional, retrospective studies have surveyed patients at varying time periods after treatment regarding their recall of symptoms during chemotherapy [9][10][11][12] and the persistence of CIPN after treatment. [13][14][15][16] However, to the best of our knowledge, there are few prospective data regarding possible discrepancies in patient-reported CIPN toxicity experience compared with clinicianassessed CIPN severity gathered continuously throughout active treatment.…”

Section: Introductionmentioning

confidence: 99%

Patient‐reported and clinician‐reported chemotherapy‐induced peripheral neuropathy in patients with early breast cancer: Current clinical practice

Nyrop

Deal

Reeder-Hayes

et al. 2019

Cancer

View full text Add to dashboard Cite

BACKGROUND: In the current study, the authors investigated the incidence of moderate to severe chemotherapy-induced peripheral neuropathy (CIPN) for chemotherapy regimens commonly used in current clinical practice for the treatment of patients with early breast cancer. Patient-reported and clinician-assessed CIPN severity scores were compared, and risk factors for CIPN severity were identified. METHODS: Patients completed a Patient-Reported Symptom Monitoring form and oncologists completed a Common Terminology Criteria for Adverse Events form. CIPN reports were collected prospectively during regularly scheduled infusion visits throughout the duration of chemotherapy. RESULTS: The sample included 184 women with a mean age of 55 years; approximately 73% were white. The 4 chemotherapy regimens used were doxorubicin and cyclophosphamide plus paclitaxel (60 patients); docetaxel and cyclophosphamide (50 patients); docetaxel, carboplatin, and anti-human epidermal growth factor receptor 2 (HER2) (24 patients); and doxorubicin and cyclophosphamide plus paclitaxel and carboplatin (18 patients). All patients treated with doxorubicin and cyclophosphamide plus paclitaxel and doxorubicin and cyclophosphamide plus paclitaxel and carboplatin received paclitaxel; all patients treated with docetaxel and cyclophosphamide and docetaxel, carboplatin, and anti-HER2 received docetaxel. The chemotherapy dose was reduced in 52 patients (28%); in 15 patients (29%), this reduction was due to CIPN. Chemotherapy was discontinued in 26 patients (14%), 8 because of CIPN. Agreement between patient-reported and clinician-assessed CIPN severity scores was minimal (weighted Cohen kappa, P = .34). Patient-reported moderate to severe CIPN was higher for paclitaxel (50%) compared with docetaxel (17.7%) (P < .001). Pretreatment arthritis and/or rheumatism (relative risk [RR], 1.58; 95% CI, 1.06-2.35 [P = .023]) and regimens containing paclitaxel (RR, 2.88; 95% CI, 1.72-4.83 [P < .0001]) were associated with higher CIPN severity. Being married (RR, 0.57; 95% CI, 0.37-0.887 [P = .01]) was found to be associated with lower CIPN severity. CONCLUSIONS: The discrepancy between patient-reported and clinician-assessed CIPN underscores the need for both patient and clinician perspectives regarding this common, dose-limiting, and potentially disabling side effect of chemotherapy. Cancer 2019;125:2945-2954.

show abstract

Moving Pharmacogenetics Into Practice: It’s All About the Evidence!

Luzum

Petry

Taylor

et al. 2021

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

The evidence for pharmacogenetics has grown rapidly in recent decades. However, the strength of evidence required for the clinical implementation of pharmacogenetics is highly debated. Therefore, the purpose of this review is to summarize different perspectives on the evidence required for the clinical implementation of pharmacogenetics. First, we present two patient cases that demonstrate how knowledge of pharmacogenetic evidence affected their care. Then we summarize resources that curate pharmacogenetic evidence, types of evidence (with an emphasis on randomized controlled trials [RCT]) and their limitations, and different perspectives from implementers, clinicians, and patients. We compare pharmacogenetics to a historical example (i.e., the evidence required for the clinical implementation of pharmacokinetics/therapeutic drug monitoring), and we provide future perspectives on the evidence for pharmacogenetic panels and the need for more education in addition to evidence. Although there are differences in the interpretation of pharmacogenetic evidence across resources, efforts for standardization are underway. Survey data illustrate the value of pharmacogenetic testing from the patient perspective, with their providers seen as key to ensuring maximum benefit from test results. However, clinicians and practice guidelines from medical societies often rely on RCT data to guide treatment decisions, which are not always feasible or ethical in pharmacogenetics. Thus, recognition of other types of evidence to support pharmacogenetic implementation is needed. Among pharmacogenetic implementers, consistent evidence of pharmacogenetic associations is deemed most critical. Ultimately, moving pharmacogenetics into practice will require consideration of multiple stakeholder perspectives, keeping particularly attuned to the voice of the ultimate stakeholder—the patient.

show abstract

Discerning the clinical relevance of biomarkers in early stage breast cancer

Cited by 9 publications

References 17 publications

Patient Preferences Regarding Chemotherapy in Metastatic Breast Cancer—A Conjoint Analysis for Common Taxanes

Patient Preferences Regarding Chemotherapy in Metastatic Breast Cancer—A Conjoint Analysis for Common Taxanes

Patient‐reported and clinician‐reported chemotherapy‐induced peripheral neuropathy in patients with early breast cancer: Current clinical practice

Moving Pharmacogenetics Into Practice: It’s All About the Evidence!

Contact Info

Product

Resources

About