Most Oncology Patients Interested in Flexible Dosing

This transcript has been edited for clarity. 
Hello. I’m Dr Maurie Markman, from City of Hope. I’d like to talk about an absolutely fascinating paper that recently appeared in JCO Oncology Practice: “The Right Dose: Results of a Patient Advocate–Led Survey of Individuals With Metastatic Breast Cancer Regarding Treatment-Related Side Effects and Views About Dosage Assessment to Optimize Quality of Life.” 
This is a very interesting analysis. This organization of patient advocates and medical oncologists, the Patient-Centered Dosing Initiative, conducted a survey of women with metastatic breast cancer regarding the patients’ treatment-related side effects. There were 1221 patients with metastatic breast cancer who completed the survey.
Some of the highlights they noted were that 86% of the women reported at least one significant treatment-related side effect, of whom 20% reported at least a visit to an emergency room for that. 
The question was asked about dosing. Now, these are women who obviously received therapy for their metastatic breast cancer, and 53% stated that they did not believe that higher doses are always more effective than lower doses. Most important, 92% of those surveyed said they were willing to discuss flexible dosing options with their oncologist based on personal characteristics and quality-of-life considerations.
I think this is a very important survey summary emphasizing that we, as oncologists, very appropriately use the data from clinical trials — whether they’re prospective clinical trials, registration trials, or other trials that are reported in the literature — to make recommendations to our patients. We pick dosages based on what the data show in those trials. 
What this survey suggests is that, obviously, patients don’t reject that in any way, shape, or form. Perhaps when you then add in the risks, some patients may say, “But if you lower the dose, would that risk be lower to me? Maybe that would be something that I would be interested in considering.” 
Again, no conclusions are drawn here, but 92% of the patients who’ve gone through the experience said they would be interested in discussing the question of flexible dosing with their oncologists. 
For practicing oncologists, those interested in policy, and those interested in patient-reported outcomes, this is a very interesting — and I believe important — paper, and I encourage you to read it. Thank you for your attention.