ACCC supports multidisciplinary breast cancer care teams with education and resources in the following areas:
HR+ HER2- breast cancer is the most common subtype of breast cancer, accounting for about 70 percent of breast cancer cases.1,2 An HR+, HER2- diagnosis can require a complex treatment regimen tailored to an individual patient, that may include hormone therapy, chemotherapy, or a combination of these.3
The complex and evolving treatment landscape for locally advanced or metastatic HR+, HER2-breast cancer poses a challenge to community oncologists, who are tasked with ensuring the tolerability and adherence of patients to their treatment regimens. Difficult dosing schedules and side effect profiles of oral anti-cancer therapies require working knowledge of a rapidly growing body of medical literature.
As oral anticancer medications become a common treatment option, patient adherence to medication is essential to ensuring positive clinical outcomes. ACCC developed the “Addressing Challenges in Oral Therapies for HR+, HER- Breast Cancer,” to identify challenges with oral anti-cancer therapies and provide methods to better support patients.
Tune-in as our expert discusses how and when to screen patients, and then connect them to available resources to better support patients’ financial needs.
In this episode, our experts examine challenges with oral anti-cancer therapies and provide methods to better support patients.
Hear how to educate patients and their caregivers about the risks and benefits to oral therapies for breast cancer.
With the emergence of oral cancer therapies, it is a very exciting time in cancer care. But these treatments can come with adverse events.
Funding and support provided by Lilly Oncology. VV-OTHR-US-DEL-0992 © Lilly USA, LLC 2022. All rights reserved.
©2022. Association of Community Cancer Centers. All rights reserved. No part of this production may be reproduced or transmitted in any form or by any means without written permission.
African Americans are disproportionately affected by the prevalence and severity of breast cancer and consistently exhibit poorer health outcomes. For example, African American women have a higher risk of developing triple negative breast cancer (TNBC)—which represents approximately 15% to 20% of all breast cancer cases—than any other racial or ethnic group. A 2021 publication from the Tigerlily Foundation found that 53% cases of TNBC are diagnosed in African American women under age 50, compared to 16% of White women.
People with TNBC have worse prognoses than those with other breast cancer subtypes. They also have a shorter time to relapse after standard chemotherapy, a higher frequency of metastases to the lung, liver, and brain, and an overall lower survival rate. A 2020 study found non-biologic contributing factors to poorer outcomes for TNBC, such as poverty, social stress, unsafe neighborhoods, and lack of healthcare access. These factors have been demonstrated to negatively affect the stage of diagnosis and length of survival for patients with TNBC.
To effectively manage TNBC, the patient must receive regular care, follow strict adherence to treatment regimens, and identify and seek support of any side effects. Although patient self-empowerment is imperative for increasing medication adherence and side effect management, it remains difficult to address in underserved populations.
ACCC is partnering with the Tigerlily Foundation to capture patient and provider perspectives on the specific challenges and barriers they encounter regarding the diagnosis and treatment of TNBC. Experts on care disparities will collect and analyze these perspectives to guide the development of specific interventions to eliminate identified knowledge and practice gaps.
As part of this initiative, we will develop a patient-provider care sequence plan that will map the entire cancer care journey, from diagnosis through treatment to survivorship care. The utility and feasibility of these plans will be assessed by implementing them at two ACCC member cancer programs. These patient-centric interventions will target the entire multidisciplinary cancer care team, as well as patients and their caregivers.
This project was made possible by support from Gilead Sciences Inc. and AstraZeneca.
Overexpression or amplification of the human epidermal growth factor receptor 2 (HER2) is present in approximately 15 percent to 20 percent of patients with metastatic breast cancer. First-line therapy with anti-HER2 targeted agents have significantly improved outcomes for patients with HER2-positive breast cancer. Nevertheless, most of these patients eventually relapse.
Novel therapies have recently become available for patients who continue to progress following first and second-line anti-HER2 targeted therapies. As the number of these therapies increases, so too does the challenge for providers to keep current on the latest clinical advances.
While anti-HER2 targeted agents have improved outcomes, they also require providers to closely monitor and manage potential treatment-related adverse events. Because many practitioners treat a wide range of tumor types; they often find it challenging to stay up to date with recent safety and efficacy data for targeted therapies. In previous ACCC educational programs, community oncology practitioners have said that keeping current with clinical advances is a primary barrier to implementing best practices in managing patients being treated by targeted therapies.
This project enabled a series of meaningful small-group interactions among clinicians involved in the care of breast cancer patients that —through a variety of collaborative educational experiences—helped them optimally manage patients with HER2-positive breast cancer who have received prior anti-HER2 targeted therapies.
This educational activity is supported by educational grants from AstraZeneca Pharmaceuticals and Daiichi Sankyo
ACCC is partnering with AXIS Medical Education in an educational research project to assess the value of a robust, independent, quality-focused educational intervention that aims to improve quality measures related to management of patients with HER2+ breast cancer (all stages). The online educational interventions offered will include clinical updates, case application, and quality processes.
The project will run approximately 12-18 months. Two ACCC Member programs have been selected to participate in baseline data collection, a practice survey, a live focus group, a series of online educational interventions, and post-intervention data collection. The project team will work closely with the participating programs to ensure a smooth and successful experience.
The Lefcourt Family Cancer Treatment & Wellness Center at Englewood Hospital and Medical Center
Research Coordinator: Christina Cancel
UNC REX Cancer Care
UNC REX Hospital
Research Coordinator: Cynthia Jones, BSHA, CPHQ
Funding & support provided by Genentech
In a recent ACCC survey of community oncology practitioners, more than 80 percent of respondents reported that 50 percent or fewer of their patients with early or metastatic breast cancer have ever had germline BRCA mutation testing. The survey revealed both patient- and provider-related barriers to BRCA testing, including institutional barriers.
To support quality improvement (QI) projects in breast cancer, ACCC has partnered with Pfizer Global Medical Grants to award more than $1.8 million in funding to 15 projects that are aimed at improving the quality of breast cancer patient care. The projects will focus on conducting quality improvement initiatives that support increasing the rates of BRCA testing for patients with early stage or metastatic breast cancer.
Access the Survey Summary Report
The grant awards are providing an opportunity for community oncology programs to implement initiatives that will address barriers to counseling and testing. The grantees will utilize innovative approaches to extend best practices to a much larger patient population, including underserved minority patient groups. As part of the initiatives, sites will review their progress and evaluate how changes in testing practices impact treatment decision-making.
The following organizations were selected to participate:
Supported by a grant from Pfizer, Inc.
Breast, Ovarian Screening Questionnaire Reveals Just 1 in 5 Women Meet NCCN Criteria for Genetic Testing
Targeted Oncology, July 21, 2020
Telementoring Program Aims to Improve Quality of Breast Cancer Care
NewsWise, July 2, 2019
Randall A. Oyer, MD, explains how ACCC is interpreting the data on genetics presented at ASCO 2018
OBR, Jan 18, 2018
Learn about open opportunities to participate in an ACCC-supported QI project, then see how ACCC's online self-assessment tools can help identify areas of improvement at your program or practice.
Presented at the 2021 ASCO Annual Meeting
Presented at the 2020 ASCO Quality Care Symposium.
Presented at the 2020 ASCO Virtual Scientific Program
For more information on any of these projects, please contact the ACCC Provider Education department.