Talking with patients about HER2+ MBC treatment options

Recommendations for deciding what information is most important to discuss with patients during initial treatment planning for HER2-positive metastatic breast cancer.

Sara A. Hurvitz, MD: Kamran, I want to turn to you. Patients struggle with a lot of information, clinicians struggle with the changing data and information available to help guide treatment decisions. More and more, we’re learning to incorporate shared decision-making with patients and it’s a pretty tricky balance. You don’t want to overwhelm patients with too much data, but you also want to share the decision with patients about what treatment you will ultimately follow. How do you handle this in your own practice? How do you sort out the amount of data to give them? Do you share clinical trial data with them? Do you show them guidelines? Are there patient materials, such as brochures, etc., that you use? How do you incorporate this into your own discussions with patients?

Kamran Ahmed, medical doctor: It’s a good question. It’s very patient-dependent. Every patient is different. For some patients, they want to see the details in terms of clinical trial data. In those cases, I will definitely pull out the clinical trials and rates and give specific numbers. In other cases, patients want to know my opinion and what I would recommend to a member of my own family. In these cases, I will specifically state what I would recommend. One of the easiest things to do is get the NCCN [National Comprehensive Cancer Network] guidelines. Moffitt Cancer Center [Tampa, Florida] is an NCCN institution and we follow these guidelines closely and if patients want to know exactly what kind of standard of care [is] right now, it’s something I also like to use. Above all, I try to tell patients that this is a team approach and while I’m here to guide them, treatment decisions are ultimately in their hands.

Sara A. Hurvitz, MD: You made a great point and talking to the patient about how they want to receive information, what they are comfortable with is certainly important. Some patients want the finer details and have already done their own research and will surprise you with very specific questions about clinical trials and others want your instincts to be based on your experience.

Transcript edited for clarity.

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