Evidence map›Paper›PMID 36198984›Full record

ArticleBreast cancer research and treatment2022

Patient-centered dosing: oncologists' perspectives about treatment-related side effects and individualized dosing for patients with metastatic breast cancer (MBC).

Anne L Loeser, Lucy Gao, Aditya Bardia, Mark E Burkard, Kevin M Kalinsky, Jeffrey Peppercorn, Hope S Rugo, Martha Carlson, Janice Cowden, Lesley Glenn and 5 more

Abstract read
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In one paragraph

Article in Breast cancer research and treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Envisioning Low-Dose Tarlatamab.JTO clinical and research reports · 2026
    Article
  2. Article
  3. Article
  4. FDA-AACR Strategies for Optimizing Dosages for Oncology Drug Products: Early-Phase Trials Using Innovative Trial Designs and Biomarkers.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025
    Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Anne L Loeser *Patient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Lucy Gao *Yale School of Medicine, New Haven, CT, USA. lgao11@partners.org.ORCID http://orcid.org/0000-0001-7825-8173
Aditya BardiaMassachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Mark E BurkardUniversity of Wisconsin Carbone Cancer Center, Madison, WI, USA.
Kevin M KalinskyWinship Cancer Institute at Emory University, Atlanta, GA, USA.
Jeffrey PeppercornMassachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
Hope S RugoUniversity of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA.
Martha CarlsonPatient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Janice CowdenPatient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Lesley GlennPatient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Julia MauesPatient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Sheila McGlownPatient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Andy NiDivision of Biostatistics, Ohio State University, Columbus, OH, USA.
Natalia PadronPatient-Centered Dosing Initiative, Salt Lake City, UT, USA.
Maryam LustbergSmilow Cancer Hospital, Yale Cancer Center, New Haven, CT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough metastatic breast cancer (MBC) is treatable, it is not curable and most patients remain on treatment indefinitely. While oncologists commonly prescribe the recommended starting dose (RSD) from the FDA-approved label, patient tolerance may differ from that seen in clinical trials. We report on a survey of medical oncologists' perspectives about treatment-related toxicity and willingness to discuss flexible dosing with patients.

methodsWe disseminated a confidential survey via social media/email in Spring 2021. Eligible respondents needed to be US-based medical oncologists with experience treating patients with MBC.

resultsOf 131 responses, 119 were eligible. Physicians estimated that 47% of their patients reported distressing treatment-related side effects; of these, 15% visited the Emergency Room/hospital and 37% missed treatment. 74% (n = 87) of doctors reported improvement of patient symptoms after dose reduction. 87% (n = 104) indicated that they had ever, if appropriate, initiated treatment at lower doses. Most (85%, n = 101) respondents did not believe that the RSD is always more effective than a lower dose and 97% (n = 115) were willing to discuss individualized dosing with patients.

conclusionTreatment-related side effects are prevalent among patients with MBC, resulting in missed treatments and acute care visits. To help patients tolerate treatment, oncologists may decrease initial and/or subsequent doses. The majority of oncologists reject the premise that a higher dose is always superior and are willing to discuss individualized dosing with patients. Given potential improvements regarding quality of life and clinical care, dose modifications should be part of routine shared decision-making between patients and oncologists.

Indexed as

Breast NeoplasmsDrug-Related Side Effects and Adverse ReactionsOncologistsFemaleHumansPatient-Centered CareQuality of LifeSurveys and QuestionnairesDose reductionIndividualized dosingMaximum-tolerated doseMetastatic breast cancerPatient-centered dosing initiativeQuality of lifeRecommended starting doseSide effectsTreatment-related toxicity

Identifiers

PMID36198984

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.