A new study, published recently in JCO Oncology Practice, found that oncologists have different perspectives on how to select starting doses for patients with metastatic cancer.1 The study shared findings from a 2021 international survey of 367 medical oncologists who treat patients with metastatic breast or gastrointestinal cancer.
Of the oncologists who reported dose reduction at initiation (52%), a majority (89%) also indicated they “usually” or “sometimes” discussed the potential trade-offs between efficacy and toxicity from different doses with their patients. The authors found that gastrointestinal specialists tended to be more likely to report dose reduction at initiation of treatment than generalists or breast specialists.
“The findings demonstrate that more data and improved approaches to drug development are needed to help oncologists and patients select the optimal dose in order to enhance patient quality of life,” said lead author of the study Rachel B. Jimenez, MD, Assistant Professor of Radiation Oncology at Harvard Medical School and Chair for Quality and Safety in the Department of Radiation Oncology at Massachusetts General Hospital.
Other key findings include the following:
The authors emphasized that the data shed light on the emerging issue of dose selection in oncology, add to the dialogue about this critical topic, and highlight the possible need for optimized or standardized dose-selection strategies. As the discussion continues to evolve, they noted clinical trials and other types of medical trials may guide oncologists and other members of the oncology care teams to follow recommended dosing that is tailored for various populations.
This manuscript is the latest ASCO initiative on optimizing dosing strategies. In May 2022, ASCO and the U.S. Food and Drug Administration co-led a virtual workshop on optimizing dosing strategies.2
1. Jimenez RB, Schenkel C, Levit LA, et al: Oncologists’ perspectives on individualizing dose selection for patients with metastatic cancer. JCO Oncol Pract. September 20, 2022 (early release online).
2. Getting the dose right: Optimizing dose selection strategies in oncology—An FDA-ASCO virtual workshop. Available at https://www.fda.gov/news-events/fda-meetings-conferences-and-workshops/getting-dose-right-optimizing-dose-selection-strategies-oncology-fda-asco-virtual-workshop-05032022. Accessed September 21, 2022.
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