High-dose chemotherapy with stem cell rescue to treat stage III homologous deficient breast cancer: factors influencing clinical implementation

BMC Cancer

Research Article

Agnes Jager¹  Vincent M. T. de Jong²  Sabine C. Linn³  Hanna M. Wijnja⁴  Valesca P. Retèl⁵  Joost G. E. Verbeek⁵  Wim H. van Harten⁵ 

[1] Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands;Department of Molecular Pathology, Antoni Van Leeuwenhoek Hospital - Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Molecular Pathology, Antoni Van Leeuwenhoek Hospital - Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Medical Oncology, Antoni Van Leeuwenhoek Hospital - Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Pathology, Utrecht University Medical Centre, Utrecht, The Netherlands;Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands;Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands;Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands;

关键词: Breast Neoplasms;    Homologous Recombination;    Drug Therapy;    Translational Research;    Qualitative Research;    Implementation Science;   

DOI  :  10.1186/s12885-022-10412-x

 received in 2022-03-01, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundHigh-dose chemotherapy with autologous stem cell rescue (HDCT) is a promising treatment for patients with stage III, HER2-negative, homologous recombination deficient (HRD) breast cancer. Clinical effectiveness and cost-effectiveness are currently under investigation in an international multicenter randomized controlled trial. To increase the chance of successful introduction of HDCT into daily clinical practice, we aimed to identify relevant factors for smooth implementation using an early comprehensive assessment framework.MethodsThis is a qualitative, multi-stakeholder, exploratory research using semi-structured interviews guided by the Constructive Technology Assessment model, which evaluates the quality of a novel health technology by clinical, economic, patient-related, and organizational factors. Stakeholders were recruited by purposeful stratified sampling and interviewed until sufficient content saturation was reached. Two researchers independently created themes, categories, and subcategories by following inductive coding steps, these were verified by a third researcher.ResultsWe interviewed 28 stakeholders between June 2019 and April 2021. In total, five overarching themes and seventeen categories were identified. Important findings for optimal implementation included the structural identification and referral of all eligible patients, early integration of supportive care, multidisciplinary collaboration between- and within hospitals, (de)centralization of treatment aspects, the provision of information for patients and healthcare professionals, and compliance to new regulation for the BRCA1-like test.ConclusionsIn anticipation of a positive reimbursement decision, we recommend to take the highlighted implementation factors into consideration. This might expedite and guide high-quality equitable access to HDCT for patients with stage III, HER2-negative, HRD breast cancer in the Netherlands.

【 授权许可】

CC BY   
© The Author(s) 2023

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