Qualitative Interviews on the Experience of Orally vs. Intramuscularly Administered Endocrine Therapy for Advanced...

The selective estrogen receptor degraders (SERD) have proven to be an effective treatment option for patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). The orally administered next-generation SERDs may be more tolerable and a preferred alternative to the intramuscularly (IM) administered fulvestrant. This study sought to identify patient and healthcare provider (HCP) perspectives on preferences, benefits, burdens, and ease of adherence of oral and IM endocrine therapy (ET).

Non-interventional, qualitative interviews were conducted in the USA, among adult patients with ER+ HER2- ABC and oncology HCPs. Eligible patients and HCPs had experience with both oral ET and fulvestrant within the past 3 years. One-on-one semi-structured interviews lasted up to 60 min.

We interviewed 25 patients and 20 HCPs. The mean time from BC diagnosis was 12.6 years (standard deviation 8.4); 18 patients (72%) were currently receiving IM and 7 (28%) oral ET. Sixteen patients (64%) preferred oral ET, mainly owing to convenience (13/16, 81%), which was considered the main benefit (22/25, 88%); side effects were a common burden (18/25, 72%). Seven patients preferred IM ET, mainly owing to the monthly injection frequency (6/7, 85%). The primary benefit of IM ET was not having to remember daily dosing (12/22, 55%), and main burdens were injection pain (21/25, 84%) and travel to receive injection (14/22, 64%). Most patients (23/25, 92%) experienced ease of adherence to oral ET. HCPs perspectives were largely aligned to the patients' experiences.

Patients with ER+ HER2- ABC in this study preferred oral to IM ET owing to convenience, and disliked the pain associated with IM ET and travel to receive injections. Compared to IM fulvestrant, oral SERDs may offer an alternative with less burden on the lives of people living with cancer.