Electronic patient reported outcomes in breast cancer patients receiving adjuvant chemotherapy with doxorubicin/cyclophosphamide combined with paclitaxel compared to patients receiving docetaxel/cyclophosphamide.

Abstract

e12519 Background: Doxorubicin/cyclophosphamide combined with paclitaxel (ACT) and docetaxel/cyclophosphamide (TC) are two of the NCCN preferred regimens for the adjuvant treatment of Her2 neu negative early stage breast cancer. Physicians often choose one regimen over the other due to the relative toxicities of each regimen. We report on the electronic patient reported outcomes (ePROs) submitted by patients during treatment with each of these regimens. Methods: Patients treated at four community oncology sites from 2022-2024 were enrolled on a proprietary ePRO system. ePRO reporting commenced with the first cycle of chemotherapy and concluded with the last cycle of chemotherapy. Results: Over the study period 325 patients receiving ACT and 310 patients receiving TC submitted an ePRO report. The median number of reports submitted was 8 (IQR: 3, 14) for ACT and 6 (IQR: 3, 9) for TC. Median age of the ACT patients was 53 (IQR 44, 61) and median age of the TC patients was 61 (IQR: 49, 69). The most common symptoms reported by all patients were fatigue, pain, and nausea. Patients receiving ACT were more likely to report nausea (52% ACT vs 45% TC), skin/nail problems (29% ACT vs 19% TC) and numbness/tingling (35% ACT vs 17%TC) and patients receiving TC were more likely to report pain (57% TC vs 49% ACT), diarrhea (36% TC vs 26% ACT), and low grade fever (13% TC vs 8% ACT). Importantly, there were no major differences in the following symptoms: appetite, physical appearance, or performance status. As expected, cardiac symptoms were more common in the ACT group (23% ACT vs 16% TC). Conclusions: Patients report a significant number of symptoms during adjuvant chemotherapy. Avoidance of doxorubicin containing regimens does not lead to elimination of significant short term treatment related symptoms. As oncologists formulate treatment plans for patients with early stage breast cancer these differences in the symptoms experienced by patients should be considered.