Supportive care prescribing: A real-world comparison of community vs. academic oncology practices.

Abstract

e23438 Background: The majority of US cancer patients are treated in community settings, which differ from academic centers in patient populations and resources. These differences may influence supportive care (SC) prescribing, but large-scale, real-world data is lacking. We analyzed a large chart audit database to quantify these prescribing patterns. Methods: A retrospective analysis of the Ipsos Oncology Monitor - a physician-reported patient record database - was conducted. Data were collected online between November 2024 - October 2025 from 1,167 cancer-treating physicians in the US who were screened for specialty and caseload, and reported on 56,001 anti-cancer drug treated patients (aggregate) across all tumor types. We compared the proportion of patients prescribed SC agents in community versus academic practices across all cancer types and within specific breast cancer (BC) subtypes and treatment regimens. Results: As detailed in Table 1 , the proportion of reported patients receiving SC between community and academic settings is statistically significant across overall cancers (66% and 55%, respectively); the magnitude of this difference varied notably by clinical context. The disparity was most pronounced for G-CSF use in eTNBC (43% vs. 7%). In contrast, for the HR+ HER2- mBC patients on CDK4/6i inhibitors (n > 1,500), prescribing patterns showed both moderate differences (Bisphosphonate use: 23% vs. 12%) and near-parity (Denosumab use: 32% vs. 29%). Conclusions: Real-world data from a large sample of patient charts in this study demonstrate a general trend of higher supportive care utilization in community oncology. However, this trend is not uniform, with patterns ranging from dramatic disparities to near-parity depending on the specific clinical scenario. These findings highlight the complex interplay of factors influencing prescribing decisions and underscore the need for further research to tease apart the drivers (e.g., patient characteristics, physician habits, guideline interpretation) behind these varied practice patterns. Supportive care (SC) use in community vs. academic practice (n = patient record forms). Patient Group / Treatment Supportive Care Agent Comm. (n) Acad. (n) Comm. (%) Acad. (%) All Cancers (Overall) Any SC 36508 19493 66% 55% eTNBC G-CSF 172 33 43% 7% HR+ HER2- mBC w/ CDK4/6i Bisphosphonate 935 584 23% 12% Denosumab 32% 29% eTNBC: early-stage triple-negative breast cancer; mBC: metastatic breast cancer.