On December 9, 2022 Sermonix Pharmaceuticals Inc., a privately held biopharmaceutical company developing innovative targeted therapeutics to specifically treat ESR1-mutated metastatic breast and gynecological cancers, reported two poster presentations at the 2022 San Antonio Breast Cancer Symposium (SABCS) evaluating the results of an online survey of ER+/HER2- metastatic breast cancer (mBC) patients (Press release, Sermonix Pharmaceuticals, DEC 9, 2022, View Source [SID1234625144]). The survey’s objectives were to better understand this patient population’s knowledge of next-generation sequencing (NGS) and ESR1 mutations, and to learn about the group’s treatment goals and quality of life (QOL) concerns.
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The QOL-focused poster also received a GRASP Advocate Choice Award. GRASP, which stands for Guiding Researchers and Advocates to Scientific Partnerships, connects patient advocates with cancer researchers to make faster and more impactful progress to improve cancer treatments. The Sermonix poster will be discussed Dec. 15 during a post-SABCS virtual session.
Conducted in June 2022, the 42-question online EQUALS (ESR1 QUAlity of Life Survey) survey drew 474 respondents. Most respondents had some knowledge of NGS, but knowledge of ESR1 mutations was lower, and discordance between physician discussion of NGS and liquid biopsies was observed. Awareness of NGS and ESR1 mutations analyzed by demographics data also suggests socioeconomic disparities in patient education and knowledge.
Other key takeaways included that patients received medical information from medical sources as well as other mBC patients; that patients are nearly equally concerned about disease progression, qualify of life and treatment side effects; that disparities in quality of life and support at home exist based on ethnicity, age and income gaps; and that mBC advocacy groups can help reach ethnically diverse populations, which may help with clinical trial recruitment or disseminating patient education.
"The foremost concerns of ER+/HER2- metastatic breast cancer patients, as well as their understanding of the rapidly changing treatment and biomarker testing environment, has not been greatly studied, especially with respect to diverse populations," said Dr. Elizabeth Attias, Sermonix chief strategy and development officer, and a co-author of the SABCS posters. "As NGS testing becomes an increasingly important component of metastatic breast cancer treatment and the molecular patient journey, the EQUALS survey results underscore the need for further education on NGS and ESR1 mutations for all patients."
Noteworthy NGS/ESR1 mutation results:
Most patients’ oncologists (63%) had discussed tumor NGS by a blood test or tumor biopsy with them, but only 50% of them had explained liquid biopsy (assessment of circulating tumor DNA from a blood draw).
Patients knew a lot/moderate amount about NGS (65%), less so of liquid biopsies (57%).
When asked if they knew what an ESR1 mutation was, just 47% knew a lot/moderate amount; only 45% of patients thought they had been tested for an ESR1 mutation.
Noteworthy QOL results:
About half of patients (48%) reported good/very good QOL, with 22% reporting poor/very poor QOL. Common side effects mostly/moderately impacting QOL were: fatigue (54%), joint pain (50%), vaginal atrophy/dryness (47%) and vasomotor symptoms (46%).
Worry about disease progression occurred often: every day (26%), a few times a week (19%) or month (28%), or only before scans (18%).
Upon progression, patients worried slightly more about efficacy of new treatment (63%) and having additional options (58%) than they did about side effects (57%).
Patients’ current treatment goals were: control cancer growth/spread (69%), prolong life (68%), tolerate side effects (67%), maintain QOL (65%) and relieve suffering/pain (60%); similar to their goals at diagnosis.
Since diagnosis, major/moderate life impacts were: side effects (57%), mental health/stress (57%), QOL (54%), finances (45%) and inability to engage in activities (41%).
Most patients (60%) thought their mBC or treatment impacted their intimate/sexual relationship negatively and more than half (62%) worried about sexual intimacy. Only 39% of patients were comfortable discussing intimacy/sexual side effects with their medical team.
Most (91%) were concerned that their treatments may have a negative impact on their bones.
"The EQUALS Survey was able to illustrate the experiences of a remarkably diverse patient population thanks to the support of patient advocacy groups such as The Chrysalis Initiative and FORCE," said Kelly Shanahan, director at Metavivor Research and Support, Inc., and a co-author of the posters. "While that itself is a success, it is also important to note that all women in the survey report a high level of anxiety and stress regardless of color."
The EQUALS Steering Committee was comprised of Shanahan; Sarah Sammons, M.D., adjunct assistant professor in the Department of Medicine at Duke University and member of the Duke Cancer Institute; Jane Meisel, M.D., associate professor of hematology and medical oncology, and associate vice chair of faculty development and promotions at Winship Cancer Institute of Emory University; and Timothy Pluard, M.D., director of the Saint Luke’s Cancer Institute and the Koontz Center for Advanced Breast Cancer.