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Metastatic breast cancer (MBC) is an incurable disease, and the focus has been on maximizing tolerated doses of chemotherapy, immunotherapy, or targeted therapy to control the disease and alleviate symptoms. These doses, often determined in clinical trials, however, may not be equally tolerated by all patients.

A new study in sheds light on an important but under-addressed aspect of cancer treatment for MBC: optimizing treatment for quality of life.

This patient advocate- and medical oncologist-led survey, conducted through an anonymous confidential survey of 1,221 patients with MBC, found that a staggering 86% experienced significant side effects, with many requiring hospitalization or missing treatments. Encouragingly, open communication with physicians was high, and dose reductions often improved patient well-being.

Perhaps most importantly, the vast majority of patients (92.3%, n = 1,127) were receptive to discussing flexible dosing regimens.

These findings challenge the traditional "one-size-fits-all" approach to treatment. This study suggests that a more nuanced approach, considering a patient's individual needs and tolerance, could be used while minimizing negative impacts on quality of life. The research also emphasizes the importance of ongoing dialogue between patients and physicians. Regular assessments of a patient's physical state and response to treatment can help determine the optimal dose for both efficacy and quality of life.

This research paves the way for further investigation into individualized dosing strategies for MBC. Future studies could explore how factors like a patient's age, overall health, and genetic makeup can influence treatment response.

In conclusion, this study makes a compelling case for a shift towards patient-centered treatment approaches in MBC.

By prioritizing open communication and exploring flexible dosing options, we can empower patients to manage their disease while living a life filled with meaning and well-being.

Arun Kumar, MD, is a hematology and oncology fellow at Medstar Georgetown University Hospital in Washington, D.C. Raj Kanwal, MBBS, is a psychiatry residency applicant in the United States.

Read the study here and an interview about it here.