Understanding the barriers to, and facilitators of, ovarian toxicity assessment in breast cancer clinical trials
Journal Title
Breast
Publication Type
Research article
Abstract
BACKGROUND: Detailed toxicity data are routinely collected in breast cancer (BC) clinical trials. However, ovarian toxicity is infrequently assessed, despite the adverse impacts on fertility and long-term health from treatment-induced ovarian insufficiency. OBJECTIVES: To determine the barriers to and facilitators of ovarian toxicity assessment in BC trials of anti-cancer drugs. METHODS: Semi-structured interviews were conducted with purposively selected stakeholders from multiple countries involved in BC clinical trials (clinicians, consumers, pharmaceutical company representatives, members of drug-regulatory agencies). Participants were asked to describe the perceived benefits and barriers to evaluating ovarian toxicity. Interviews were transcribed verbatim, coded in NVivo software and analysed using inductive thematic analysis. RESULTS: Saturation of the main themes was reached and the final sample size included 25 participants from 14 countries (9 clinicians, 7 consumers, 5 members of regulatory agencies, 4 pharmaceutical company representatives); half were female. The main reported barrier to ovarian toxicity assessment was that the issue was rarely considered. Reasons included that these data are less important than survival data and are not required for regulatory approval. Overall, most participants believed evaluating the impact of BC treatments on ovarian function is valuable. Suggested strategies to increase ovarian toxicity assessment were to include it in clinical trial design guidelines and stakeholder advocacy. CONCLUSION: Lack of consideration about measuring ovarian toxicity in BC clinical trials that include premenopausal women suggest that guidelines and stronger advocacy from stakeholders, including regulators, would facilitate its more frequent inclusion in future trials, allowing women to make better informed treatment decisions.
Keywords
*Antineoplastic Agents/toxicity; *Breast Neoplasms/drug therapy; *Clinical Trials as Topic; Female; Humans; *Ovary/drug effects; Premenopause; Qualitative Research; Research Design/standards; Breast cancer; Clinical trials; Fertility; Menopause; Ovarian insufficiency
Department(s)
Medical Oncology; Laboratory Research
PubMed ID
35597179
Open Access at Publisher's Site
https://doi.org/10.1016/j.breast.2022.05.002
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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Last Modified: 2024-10-18 05:07:17

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