A survey evaluating patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer and medical oncologists have found that many patients who switched to a trastuzumab biosimilar from the reference product (Herceptin) n were not given enough information about biosimilars before the switch.

The conclusions, which were Posted in Breast cancer research and treatment, found that patients were often not told what a biosimilar was or why they were being switched, were not given the opportunity to switch, or were not told at all that they were being switched. The authors of the article raised concerns that the lack of notification about changes and education about biosimilars is an ethical issue, with patients being the ones who are disadvantaged.

“Patients have a right to be informed about their treatment… Without information about their care, patients have no agency, which is even more in conflict with the goals of patient-centered care,” the researchers said.

Two surveys were developed and distributed across the United States to characterize experiences with trastuzumab biosimilars: 1 for patients and 1 for healthcare professionals. The survey was completed by 143 patients with HER2 positive breast cancer and 33 medical oncologists. The average age was 49.59 years for patients and 46.16 years for oncologists.

Overall, 63.9% of patients reported switching from Herceptin to a trastuzumab biosimilar and 55.2% reported being offered the option to switch, of which 8.6% declined.

In 40.8% of the responses from those who switched, patients said they were not told beforehand that they would be switching to a biosimilar. Many patients said the lack of notification caused negative emotions about the change. Only 11% of patients said they were satisfied with the information they received about biosimilars and the switch.

Over 60% (61.0%) of patients reported learning about biosimilars through self-directed learning, compared to 33.3% who learned from their provider and 35.2% who learned by asking questions on social networks.

In total, 41.0% of patients said they wanted more time to discuss the switch with a doctor, 35.0% wanted more time between notification and the switch, 52.5% wanted to have a better understanding of biosimilars, 41.3% wanted to have access to printed educational materials. Additionally, 54.8% of patients said they had not received any educational materials from a pharmaceutical manufacturer.

The survey results also revealed that oncologists were not always aware that patients were switching to a biosimilar.

“Despite their central role in the care of cancer patients, oncologists lack comprehensive information. It is important to identify the information that oncologists need both for their own situational awareness and to foster relationships with their patients. Ultimately, effective communication about trastuzumab biosimilars is not the sole responsibility of individual oncologists, but rather a goal requiring system-level interventions,” the researchers commented.

The researchers recommended a greater focus in studies on patients and their caregivers to inform treatment decisions and future guidelines.

“To develop tailored interventions, it is necessary to characterize the experience not only of clinicians (as traditional), but also of patients, their families, and caregivers through research methods such as surveys and interviews. focused on obtaining lived experiences and unpacking decision points and knowledge gaps Findings should be used to inform the development and evaluation of interventions, resulting in practices tailored to the needs of patients and clinicians,” the authors wrote.

Reference

Papautsky EL, Carlson M, Johnson SM, Montague H, Attai DJ, Lustberg MB. Characterizing Non-Medical Switching Experiences to Trastuzumab Biosimilars Using Data from Online Surveys of US Oncologists and Breast Cancer Patients. Breast cancer treatment. 2022;194(1):25-33. doi:10.1007/s10549-022-06615-2