Sánchez-Rovira Pedro, Zamora Pilar, Salvador-Bofill Javier, Morales Serafín, Martínez-Jáñez Noelia, Martínez-de-Dueñas Eduardo, Lluch Ana, Illarramendi José Juan, Gómez-Pardo Patricia, Gavilá Gregori Joaquín, García-Palomo Andrés, García-Mata Jesús, Fernández Yolanda, Del Barco Sonia, de Juan Ana, Ciruelos Eva, Chacón José Ignacio, Calvo Lourdes, Barnadas Agustí, Albanell Joan
Complejo Hospitalario de Jaén, Jaén, Spain.
Hospital Universitario La Paz, Madrid, Spain.
J Drug Assess. 2019 Apr 8;8(1):62-69. doi: 10.1080/21556660.2019.1604375. eCollection 2019.
The aim of this survey conducted by 20 leading Spanish oncologists was to analyze the concurrence between Spanish clinical practice and the recently published definition of the optimal sequence for the systemic treatment of metastatic breast cancer (MBC) according to patient profiles. A self-administered questionnaire was developed, divided into five sections comprising 34 specific questions related to sequential treatments, plus three additional general questions. Respondents were asked to justify negative answers. Participants were recruited randomly by invitation out of a total of 619 oncologists. The questionnaire was sent and collected via e-mail between October 2015 and May 2016. A total of 191 completed questionnaires were received. Overall, 70% of oncologists would keep the three patient profiles exactly as proposed (hormone receptor-positive and HER2-negative, HER2-positive, and triple negative breast cancer). Affirmative answers to questions regarding treatment sequences for these patient profiles (1-34) ranged from 77.8-99.5%, with an average of 90.9% of oncologists being in agreement with the recommended sequential treatments. The lowest degree of consensus was observed for endocrine treatments in pre-menopausal women and for chemotherapy options in hormone-resistant patients, whilst the highest degree of consensus was reached for targeted therapies in HER2-positive patients and for endocrine therapy in post-menopausal women. In their comments, participants revealed a number of economic constraints that prevented them from implementing some of the best treatment options. In conclusion, despite the complexity of MBC treatment, there is general agreement on the optimal treatment sequences.
这项由20位西班牙顶尖肿瘤学家开展的调查旨在分析西班牙的临床实践与最近发布的根据患者情况制定的转移性乳腺癌（MBC）全身治疗最佳序列定义之间的一致性。设计了一份自填式问卷，分为五个部分，包含34个与序贯治疗相关的具体问题，外加三个一般性问题。要求受访者对否定答案作出解释。从总共619名肿瘤学家中随机邀请招募参与者。问卷于2015年10月至2016年5月通过电子邮件发送和收集。共收到191份完整问卷。总体而言，70%的肿瘤学家会完全按照提议保留这三种患者情况（激素受体阳性且人表皮生长因子受体2阴性、人表皮生长因子受体2阳性和三阴性乳腺癌）。对于这些患者情况（1 - 34）的治疗序列问题，肯定回答的比例在77.8% - 99.5%之间，平均有90.9%的肿瘤学家同意推荐的序贯治疗。绝经前女性的内分泌治疗以及激素抵抗患者的化疗方案的共识度最低，而人表皮生长因子受体2阳性患者的靶向治疗以及绝经后女性的内分泌治疗的共识度最高。在评论中，参与者揭示了一些经济限制因素，这些因素阻碍了他们实施一些最佳治疗方案。总之，尽管MBC治疗复杂，但对于最佳治疗序列存在普遍共识。
