UNDERSTANDING KEY SYMPTOMS, SIDE EFFECTS AND IMPACTS OF HR+ AND HER2- ADVANCED BREAST CANCER: LITERATURE REVIEW AND EXPERT INTERVIEWS

OBJECTIVES: While patients with HR+/HER2- advanced breast cancer experience a wide range of disease-related symptoms, side effects, and impacts, identifying the most important and relevant concepts of interest can allow for generalization of the patient experience. This study sought to describe these commonalities based on a review of the literature and interviews with therapeutic experts. METHODS: Literature reviews were conducted in MEDLINE it, Embase, and PsycINFOti to identify articles relevant to study goals (search terms included "breast cancer," "metastatic," "advanced," and "symptoms OR side effects OR impacts"; articles published from March 2005 to February 2016 were considered for inclusion). Individual telephone interviews were conducted with five US-based breast cancer oncologists. RESULTS: Literature reviews identified 13 eligible studies. Disease-related symptoms were described for six metastatic sites. Six treatment types and their side effects were described. Nausea/vomiting, pain, weight changes, and diarrhea were reported in at least half of these treatments. Emotional and physical impacts of cancer and treatment were reported most frequently. Interviews with experts identified disease-related symptoms for 10 metastatic sites. Pain, fatigue, loss of appetite, and nausea were reported as symptoms generalizable to all HR+/HER2-breast cancer patients, regardless of location of metastasis. Pain and fatigue were reported by three experts as both the most severe and most bothersome disease-related symptoms. Four types of treatment were discussed. Fatigue was reported by three experts as generalizable to all metastatic sites discussed, and relevant to all treatments discussed. The majority of reported impacts focused on physical functioning. CONCLUSIONS: Literature and expert perspectives suggest that patients with HR+/HER2- advanced breast cancer commonly experience pain and fatigue as disease-related symptoms; nausea/vomiting, pain, weight changes, diarrhea, and fatigue as treatment-related side effects; and impacts on physical functioning, regardless of the location of their metastases.