TY - JOUR
T1 - Optimal Supportive Care for Patients With Metastatic Breast Cancer According to Their Disease Progression Phase
AU - Kida, Kumiko
AU - Olver, Ian
AU - Yennu, Sriram
AU - Tripathy, Debu
AU - Ueno, Naoto T.
N1 - Funding Information:
This research was supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant, P30CA016672, Morgan Welch Inflammatory Breast Cancer Research Program, and State of Texas Rare and Aggressive Breast Cancer Research Program Grant, and by the Nellie B. Connally Breast Cancer Research Fund.
Publisher Copyright:
© 2021 by American Society of Clinical Oncology.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - The clinical progression patterns of metastatic breast cancer (MBC) are heterogeneous; patients experience acute and stable phases at different time points. The acute phase consists of rapid progressive symptomatic changes, whereas in the stable phase, patients have relatively low symptom burden. Therefore, personalized interdisciplinary care is essential. The optimal palliative or supportive care in MBC is to provide comprehensive care that is individually prioritized to the patient’s disease status. The purpose of this review is to provide a practical guide for oncologists to understand the priorities for supportive care for patients with MBC in the two phases. We note that for better decision making in patient care, performance status should be broadened to consider not only physical status but also psychosocial needs and cognitive condition. We summarize the clinical importance of physical symptom control, psychosocial support, physical activity, nutrition support, and advance care planning. For optimal care, we present palliative or supportive care checklists according to the disease progression phase, combining the limited evidence with expert input. In the acute phase, close monitoring of the patient’s status and symptom management take priority. In the stable phase, the focus can shift to maintenance or improvement of physical strength and emotional condition. Finally, we discuss future directions and unmet needs in providing the best supportive care for patients with MBC.
AB - The clinical progression patterns of metastatic breast cancer (MBC) are heterogeneous; patients experience acute and stable phases at different time points. The acute phase consists of rapid progressive symptomatic changes, whereas in the stable phase, patients have relatively low symptom burden. Therefore, personalized interdisciplinary care is essential. The optimal palliative or supportive care in MBC is to provide comprehensive care that is individually prioritized to the patient’s disease status. The purpose of this review is to provide a practical guide for oncologists to understand the priorities for supportive care for patients with MBC in the two phases. We note that for better decision making in patient care, performance status should be broadened to consider not only physical status but also psychosocial needs and cognitive condition. We summarize the clinical importance of physical symptom control, psychosocial support, physical activity, nutrition support, and advance care planning. For optimal care, we present palliative or supportive care checklists according to the disease progression phase, combining the limited evidence with expert input. In the acute phase, close monitoring of the patient’s status and symptom management take priority. In the stable phase, the focus can shift to maintenance or improvement of physical strength and emotional condition. Finally, we discuss future directions and unmet needs in providing the best supportive care for patients with MBC.
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U2 - 10.1200/OP.20.00622
DO - 10.1200/OP.20.00622
M3 - Article
C2 - 33492987
AN - SCOPUS:85104276322
SN - 2688-1527
VL - 17
SP - 177
EP - 183
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 4
ER -