Surveys Probe Biosimilars in Oncology

A handful of recent studies examined patient and oncologist perceptions about biosimilar switching and oncology patient mental health.

Investigators found that oncologists and patients often see eye-to-eye on biosimilar switching, which involves a change from the reference drug, often more costly, to the biosimilar version of the same drug.¹

The switching surveys, presented at 2021 San Antonio Breast Cancer Symposium, found that oncologists were more likely to conclude that information about the switch was presented clearly (58% vs 42%) or that patients had been given ample opportunity to ask questions (59% vs 35%).

Oncologists were more likely to conclude that the information resources provided to patients about the switch were sufficient (33% vs 18%). Patients, however, were less likely than oncologists to come away with the impression that their cancer would be treated as effectively with a biosimilar as with a reference product (43% vs 79%).

The studies concerned patients with breast cancer who had undergone treatment with trastuzumab (Herceptin) and were switched to a biosimilar. Although oncologists have led the charge in adopting biosimilars, there remain pockets of doubt and hesitancy about these agents, which constitute barriers to uptake.

Biosimilars are FDA-approved versions that are highly similar to the brand drugs they reference. Efficacy, safety, and immunogenicity are each weighed in reaching that regulatory decision. Switching drugs in oncology is a delicate issue because much is at stake in treating a cancer that may be aggressive and/or advanced.

In the surveys, which were issued separately to oncologists and patients, there were similarities in perception when it came to patients feeling involved in care decisions, trust between oncologists and patients, patient understanding of the reasons for switching to biosimilars, and patients being able to adjust emotionally to the switch.

Oncology Patients and Mental Health

In a Cardinal Health survey released recently, more than 90% of oncologists who participated agreed that that patient mental health has a significant effect on outcomes, “and more than 80% frequently see some form of mental illness or distress in patients.”²

According to the findings, 26% of oncologists said they very frequently see patients with cancer who are coping with some form of mental illness, such as depression, anxiety or distress. Another 55% said they frequently see patients who are grappling with these problems.

In addition, although 6 of 10 oncologists discuss mental health issues with their patients frequently or very frequently, most “only occasionally” refer their patients for mental health services.

According to the survey, the mental health issues most commonly seen by oncologists include:

• Anxiety (83%)
• Mood, including depression (81%)
• Personality disorders (23%)
• Addiction (21%)
• Post-traumatic stress disorder (17%)

Although they generally do not refer patients for mental health treatment, oncologists do prescribe drugs for coping with these disorders.

“The vast majority of participating oncologists said they have prescribed antidepressants (93%) and anxiolytics (95%) as a new treatment for patients with a cancer diagnosis," noted the investigators.

They also said two-thirds of oncologists screen for distress in their patients, and about 45% of survey respondents said their practices or clinics have social workers available to work with patients.

The survey also addressed barriers to rendering palliative care for patients, which included insufficient training and preparation for oncologists to effectively respond to this need. According to the survey, 74% of participants agreed better tools are needed for educating patients with cancer about palliative care options.

References

1. Papautsky EL, Carlson M, Lustberg M. The patient-centered paradox: A US-based survey of oncologist- and patient-reported experiences with trastuzumab biosimilars. Presented at: SABCS 2021; December 7-10, 2021. Poster P2-13-13.
2. Feinberg B, Gajra A; Cardinal Health. Views from specialty physicians nationwide on mental health and palliative care impacts for patients with cancer. Oncology Insights. December 2021. Accessed December 13, 2021. cardinalhealth.com/en/services/specialty-physician-practice/resources/whitepapers-and-downloads/oncology-insights.html