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William J. Gradishar, MD, FACP, FASCO


ESMO 2023: Standardized Coaching Program May Improve Oral Treatment of Advanced Breast Cancer

By: Julia Fiederlein Cipriano, MS
Posted: Tuesday, November 7, 2023

The implementation of a standardized patient coaching program—the Multinational Association for Supportive Care in Cancer (MASCC) oral agent teaching tool (MOATT)—for patients with hormone receptor–positive, HER2-negative advanced breast cancer lowered the risk of permanent treatment discontinuation by approximately 40% during the first 6 months of oral therapy, according to Manfred K. Welslau, MD, of Onkologie Aschaffenburg, Germany, and colleagues. Presented during the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract 378O), these first results of the IMPACT trial may also be used to improve therapy management in the adjuvant setting.

“Recent studies showed the positive impact of supportive care programs on patients,” the investigators remarked. In this analysis, a total of 211 patients who were undergoing oral treatment with the CDK4/6 inhibitor abemaciclib plus endocrine therapy were randomly assigned to receive coaching within the MOATT program or via a local routine intervention.

After 24 weeks, the persistence probability was 0.71 with local routine coaching and 0.82 with the MOATT approach (hazard ratio = 0.59; log-rank P = .078). Disease progression or death led to the discontinuation of treatment in 14 cases in the local routine coaching arm and in 10 cases in the MOATT arm. In 14.1% and 7.8% of the patients who received coaching with the local routine intervention and MOATT approach, respectively, a decision was made for the permanent discontinuation of treatment with abemaciclib within the first 24 weeks.

The planned dose reduction rate was higher in patients who received coaching with the local routine intervention than with the MOATT approach (24.5% vs 17.2%). Therapy interruptions were planned in 14.9% and 10.1% of the local routine coaching and MOATT arms, respectively.

Disclosure: Dr. Welslau reported no conflicts of interest. For full disclosures of the other study authors, visit

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