M Bartoletti

Controversies in monitoring metastatic breast cancer during systemic treatment. Results of a GIM (Gruppo Italiano Mammella) survey

BACKGROUNDnThe optimal strategy for monitoring metastatic breast cancer (M-MBC) is unclear. Nevertheless, M-MBC influences patients quality of life and it affects the use of resources in terms of both drugs and diagnostic exam prescription. We aim to disclose oncologists approach on M-MBC, identifying controversial areas.nnnMETHODSnAn anonymous online survey was conducted among GIM members who, based on their on-field experience, shared their own method for M-MBC planning. Chi-square tests and Fisher exact tests were used as appropriate.nnnRESULTSnThe survey was completed by 256 recipients (51%). The majority of them were medical oncologists. Approximately 50% of respondents reported that M-MBC was primarily based on the monitoring strategies used in clinical trials, and for 70% of them M-MBC should be evidence-based. Areas of controversies included the primary goal of M-MBC, the use of tumour markers, the optimal timing for baseline assessment and frequency of repeating testing. Respondents agreed on planning M-MBC before treatments start and on discussing with the patient about the M-MBC strategy and on choosing CT-scan as the preferred reassessment imaging method. The most relevant factors influencing the M-MBC strategy were performance status, triple negative histology, exams contraindication, the presence of clinically measurable disease, and treatment safety profile; on the contrary, patients socio-economic status, exams cost, and hospitals logistic limits were less relevant. Experienced oncologists seemed less prone to intensive follow-up.nnnCONCLUSIONnM-MBC strategy still has controversial issues and its potential clinical effects for breast cancer patients need ad hoc studies.

Use and perception of complementary and alternative medicine among cancer patients: the CAMEO-PRO study

BackgroundIt is estimated that about half of cancer patients use at least one form of complementary and alternative medicines (CAM) in their life but there is a strong reticence of patients in talking about CAM with their oncologist. Primary aim of this study was to inform patients about CAM, focusing on their supposed benefits, toxicities and interactions with conventional therapeutic agents. The study also explored patients’ perception about CAM and ascertained the level of CAM use among cancer patients of an Italian academic hospital.MethodsFrom April 2016 to April 2017, the observational pilot trial “CAMEO-PRO” prospectively enrolled 239 cancer patients that were invited to attend a tutorial about CAM at the Department of oncology, University Hospital of Udine, Italy. Before and after the informative session, patients were asked to fill a questionnaire reporting their knowledge and opinion about CAM.ResultsOverall, 163 (70%) women and 70 (30%) men were enrolled. Median age was 61xa0years. At study entry, 168 (72%) patients declared they had never been interested in this topic previously; 24 patients (11%) revealed the use of a type of alternative therapy and 58 (28%) revealed the use of complementary therapy. In total, 139 (55.2%) patients attended the informative session. Bowker’s test of symmetry demonstrated statistically significant opinion’s change after the session on 9 out of 14 explored items.ConclusionsInformative sessions seem to have a relevant impact on patients’ perceptions and opinions about CAM.