Dr Meisel on the Impact of Endocrine Therapy–Related Toxicities on QOL in ER+/HER2– Breast Cancer

Jane L. Meisel, MD, associate professor, Department of Hematology and Medical Oncology, associate professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, discusses the impact of toxicities associated with endocrine therapy on quality of life (QOL) as reported by patients with metastatic breast cancer. 

In the context of incurable cancer, prioritizing patients’ QOL is paramount, Meisel begins. To further elucidate patient concerns and perspectives on treatment-related adverse effects (TRAEs) and QOL, Meisel and colleagues conducted a survey of patients with estrogen receptor–positive, HER2-negative metastatic breast cancer on the AEs they experienced during cancer treatment and how toxicity concerns factor into treatment decision making.

Results showed that approximately 70% of patients consider QOL an extremely important factor in treatment decisions, Meisel reports. This underscores the necessity of integrating patient-centric considerations into treatment discussions, such as the dosing frequency, administration method (oral or intravenous), common toxicities to expect, and their impact on daily life, Meisel details. Engaging in conversations about which TRAEs are most significant to patients also aids in selecting treatments that align with their preferences, she emphasizes.

In a predominantly endocrine therapy-receiving population, common AEs impacting QOL were sexual dysfunction, joint pain, and vaginal dryness, Meisel continues. Other impactful TRAEs reported, such as fatigue, bone pain, and hair loss, can negatively influence patients’ careers, relationships, and mental health, she adds. This highlights the misconception that endocrine therapy does not have the potential to significantly affect daily life, Meisel states.

Additional assessment of patients’ decisional regret revealed that 46% of patients expressed regret about taking a cancer medication due to toxicities, Meisel notes. These findings underscore the need for holistic patient-centered care, acknowledging the multifaceted impact of TRAEs on patients’lives beyond the clinical setting, she concludes.