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19.03.2021 | Clinical trial

A qualitative study to evaluate physician attitudes regarding omission of surgery among exceptional responders to neoadjuvant systemic therapy for breast cancer (NRG-CC006)

verfasst von: Laila A. Gharzai, Lauren A. Szczygiel, Dean A. Shumway, Hanna Bandos, Thomas B. Julian, Eleftherios P. Mamounas, Julia White, Jennifer F. De Los Santos, Mark Basik, Patricia A. Ganz, Reshma Jagsi

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2021

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Abstract

Purpose

Accrual to clinical trials that challenge well-established treatment paradigms represents a unique challenge. Physician opinions on investigation of a novel approach to breast cancer treatment, in which patients with complete response to neoadjuvant chemotherapy are offered omission of lumpectomy, are unknown. NRG-CC006 sought to describe physician attitudes toward a novel approach to breast cancer treatment.

Methods

We recruited 18 participants in the fields of surgery, medical oncology, and radiation oncology to participate in the semi-structured telephone interviews. Main outcomes are qualitative themes associated with omission of surgery.

Results

Of 18 interview participants, specialty and gender were evenly represented across surgery, medical oncology, and radiation oncology. Qualitative themes included general attitudes toward treatment de-escalation, stakeholder considerations, and trial/protocol considerations. The vast majority of participants expressed interest in investigation of omission of surgery, with all participants endorsing need for further investigation into treatment de-escalation. Stakeholder considerations in opening such a trial emphasized need for multidisciplinary involvement and, particularly, the unique role of surgeons as gatekeepers in breast cancer treatment. Finally, participants endorsed a need for further foundational studies to develop ways to predict complete pathologic response to chemotherapy without surgical intervention.

Conclusions

Physicians expressed interest in investigating a novel approach to breast cancer treatment that would omit surgery in complete responders to neoadjuvant chemotherapy. Multidisciplinary input, and specifically surgeon engagement, will be key to the success of future investigations. Ongoing work to develop approaches to predict pathologic complete response accurately is needed to achieve the promise of this idea.

ClinTrials #: BR005: NCT03188393 June 13, 2017

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Titel: A qualitative study to evaluate physician attitudes regarding omission of surgery among exceptional responders to neoadjuvant systemic therapy for breast cancer (NRG-CC006)
verfasst von: Laila A. Gharzai
Lauren A. Szczygiel
Dean A. Shumway
Hanna Bandos
Thomas B. Julian
Eleftherios P. Mamounas
Julia White
Jennifer F. De Los Santos
Mark Basik
Patricia A. Ganz
Reshma Jagsi
Publikationsdatum: 19.03.2021
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2021
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-021-06172-0

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A qualitative study to evaluate physician attitudes regarding omission of surgery among exceptional responders to neoadjuvant systemic therapy for breast cancer (NRG-CC006)