Physicians, Nurses Can Improve Treatment Compliance With CDK 4/6 Inhibitors in Metastatic Breast Cancer

By Kerri Fitzgerald - Last Updated: June 14, 2022

A study identified self-reported gaps from healthcare providers (HCPs) associated with providing treatment-related support to patients with metastatic breast cancer. Areas for improvement include setting expectations about treatment side effects and discussing the patient’s role in reporting potential side effects.

Combination cyclin-dependent kinase (CDK) 4/6 inhibitors plus endocrine therapy has improved outcomes for patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced or metastatic breast cancer. Despite this fact, some patients discontinue CDK 4/6 therapy. A study presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting assessed how HCPs define their role in educating patients on treatment-related side effects to improve treatment compliance and reduce early discontinuation of CDK 4/6 inhibitors.

Using a sequential mixed-methods design, investigators conducted 45-minute phone interviews (n=25) with HCPs that then informed the development of an online survey (n=193). The survey was distributed to medical oncologists (n=64), oncology registered nurses (RNs; n=64), and nurse practitioners/physician assistants (NPs/PAs; n=65) in the community-based setting.

In general, 26% to 48% of those surveyed reported suboptimal knowledge of side effects related to specific CDK 4/6 inhibitors (abemaciclib, ribociclib, and palbociclib). Interviewees noted that educating patients and setting expectations on potential side effects was critical, but 52% of medical oncologists reported suboptimal skill in doing so compared with 42% of NPs/PAs and 20% of RNs.

Most HCPs (68% of medical oncologists, 85% of NPs/PAs, and 91% of RNs) expect patients to be able to report all side effects, while less than one-third explain to patients their role in reporting side effects (31%, 26%, and 16%, respectively). Half of medical oncologists believe compliance to prescribed medications is entirely in the patient’s hands compared with just 17% of NPs/PAs and 16% of RNs. Less than half of HCPs (44% to 45%) openly discuss conventional and alternative medications patients are taking.

“This study identified areas where HCPs can improve their ability to counsel patients and address concerns that may influence a patient’s decision to prematurely discontinue therapy and should be used to inform future professional development initiatives,” the researchers concluded.


O’Sullivan CCM, Jacobs G, Perez DG, et al. Supporting patients with metastatic breast cancer during therapy with cyclin-dependent kinase 4/6 (CDK) inhibitors: A needs assessment. Abstract #e13054. Presented at the 2022 American Society of Clinical Oncology Annual Meeting; June 3-7, 2022; Chicago, IL.

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