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

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

High-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...

Full description

Saved in:
Bibliographic Details
Published in:BMC cancer Vol. 23; no. 1; p. 26
Main Authors: Verbeek, Joost G E, de Jong, Vincent M T, Wijnja, Hanna M, Jager, Agnes, Linn, Sabine C, Retèl, Valesca P, van Harten, Wim H
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 07-01-2023
BioMed Central
BMC
Subjects:
BRCA mutations
Breast cancer
Breast Neoplasms
Breast Neoplasms - drug therapy
Breast Neoplasms - genetics
Cancer
Care and treatment
Chemotherapy
Cost benefit analysis
Drug Therapy
Female
Health aspects
Health Personnel
Homologous Recombination
Humans
Implementation Science
Medical law
Methods
Patient outcomes
Qualitative Research
Stem cell research
Stem Cells
Translational Research
Transplantation
Treatment Outcome
Tumor staging
Netherlands
Homologous Recombination
Qualitative Research
Breast Neoplasms
Implementation Science
Drug Therapy
Translational Research
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:High-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. This 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. We 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. In 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.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-022-10412-x