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Time Toxicity of Endocrine-based Oral CDK4/6 Inhibitor Therapies.

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Adjuvant CDK4/6 inhibitor therapy for early breast cancer requires travel, impacting patient time and CO2 emissions. Centralized management in Germany leads to significant travel distances and environmental impact.

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Area of Science:

  • Oncology
  • Pharmacoeconomics
  • Environmental Health

Background:

  • Adjuvant endocrine therapy with CDK4/6 inhibitors is crucial for HR+/HER2- early breast cancer.
  • Current management involves regular visits to specialized breast cancer centers, primarily in Germany.
  • This necessitates patient travel, lab assessments, and side effect monitoring.

Purpose of the Study:

  • To estimate travel distances, times, and CO2 emissions associated with centralized adjuvant CDK4/6 inhibitor therapy.
  • To analyze the logistical and environmental impact of oral cancer therapies in Germany.
  • To inform strategies for optimizing the delivery of oral cancer treatments.

Main Methods:

  • Retrospective analysis of early breast cancer cases from Ulm, Lübeck, and Tübingen university hospitals.
  • Identification of patients eligible for ribociclib or abemaciclib based on monarchE and NATALEE criteria.
  • Calculation of travel metrics assuming 24 visits over 3 years (ribociclib) and 18 visits over 2 years (abemaciclib).

Main Results:

  • 1080 HR+/HER2- patients were included in the analysis.
  • Median travel for ribociclib (3 years): 1200 km, 24.0 hrs driving, 176.0 kg CO2.
  • Median travel for abemaciclib (2 years): 900 km, 18.0 hrs driving, 132.3 kg CO2.

Conclusions:

  • Centralized management of adjuvant CDK4/6 inhibitors in Germany results in substantial patient travel and CO2 emissions.
  • The increasing use of oral cancer therapies highlights the need for optimized delivery strategies.
  • Collaboration among stakeholders is essential to enhance the safety, feasibility, and efficacy of oral cancer treatments.