To improve the quality of care for patients with breast cancer, an analysis of the health-care pathway, considering feedback from both health-care practitioners (HCPs) and patients, is needed. Between 2020 and 2022, we conducted a survey at French breast cancer centers and analyzed information from questionnaires completed by HCPs and patients. We collected information on center organization, diagnostic processes, treatment decisions and modalities, supportive care, patient advocacy groups, and work issues. Twenty-three breast cancer centers were included and questionnaires completed by 247 HCPs and 249 patients were analyzed. The centers closely followed the legal French framework for cancer treatments, which includes formal diagnostic announcements, multidisciplinary tumor boards, personalized treatment summaries, and supportive care access. HCPs and patients were satisfied with the time to diagnosis (≤ 2 weeks as evaluated by 75

The objective of the CHEOPS trial was to assess the benefit of adding aromatase inhibitor (AI) to metronomic chemotherapy, oral vinorelbine, 50 mg, three times a week for pre-treated, HR + /HER2- metastatic breast cancer patients. In this multicentric phase II study, patients had to have progressed on AI and one or two lines of chemotherapy. They were randomized between oral vinorelbine (Arm A) and oral vinorelbine with non-steroidal AI (Arm B). 121 patients were included, 61 patients in Arm A and 60 patients in Arm B. The median age was 68 years. 109 patients had visceral metastases. They all had previously received an AI. The study had been prematurely stopped following the third death due to febrile neutropenia. Median PFS trend was found to be different with 2.3 months and 3.7 months in Arm A and Arm B, respectively (HR 0.73, 95%CI 0.50–1.06, p value = 0.0929). No statistical difference was shown in OS and better tumor response. 56 serious adverse events corresponding to 25 patients (21%) were reported (respectively, 12 (20%) versus 13 (22%) for arms A and B) (NS). The addition of AI to oral vinorelbine over oral vinorelbine alone in aromatase inhibitor-resistant metastatic breast cancer was associated with a non-significant improvement of PFS. Several unexpected serious adverse events were reported. Metronomic oral vinorelbine schedule, at 50 mg three times a week, requires close biological monitoring. The question of hormonal treatment and chemotherapy combination remains open.

BACKGROUND/AIM:Olaparib was approved in 2014 by the European Medicines Agency (EMA) as maintenance treatment for patients with breast cancer gene (BRCA)-mutated platinum-sensitive relapsed high-grade epithelial ovarian cancer (EOC) following the results of the Study 19. We present the results of a national real-world study on the effectiveness of olaparib in relapsed BRCA-mutated EOC patients.PATIENTS AND METHODS:Patients with EOC, peritoneal, and/or fallopian-tube cancer treated with olaparib in a French Center between May 2014 and March 2017 were included. The primary end-point of the study was progression-free survival.RESULTS:Of the 128 patients analyzed, 89 were treated according to the EMA label. The median progression-free survival was 17.0 months. The most common treatment-related toxicity was fatigue. Treatment-related myelodysplastic syndrome (n=5) and a second cancer (n=1) were diagnosed.CONCLUSION:In this real-life setting, olaparib confirmed its efficacy and safety profile, as previously shown in clinical trials.

The DESTINY-Breast04 trial (NCT03734029) demonstrated significantly improved progression-free survival (PFS) and overall survival (OS) in pts with HER2-low mBC treated with T-DXd vs TPC. Consistent efficacy was also demonstrated in pts with BMs at baseline with T-DXd vs TPC. In this exploratory analysis, we provide additional intracranial (IC) efficacy data in pts with BMs at baseline. Pts with centrally confirmed HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+/in situ hybridization−) mBC who were previously treated with 1 or 2 lines of chemotherapy were randomized (2:1) to T-DXd or TPC. Pts with investigator-assessed clinically stable and treated BMs at baseline were eligible, and exploratory analyses of IC clinical activity were completed. Analysis was based on central review of brain MRI or CT scans. Endpoints included IC objective response rate (ORR) by blinded independent central review (BICR), best overall response, clinical benefit rate, disease control rate, and IC PFS by BICR. Of 35 pts with BICR-assessed BMs at baseline, 24 pts received T-DXd and 11 received TPC. Like the full dataset, most pts with BMs at baseline had hormone receptor-positive tumors (T-DXd, 75.0%; TPC, 72.7%). Of those pts who received ≥1 dose of trial drug, median treatment duration was 6.6 mo (mo; range, 0.3-24.3 mo) for T-DXd (n = 24) and 1.4 mo (range, 0.4-17.4 mo) for TPC (n = 9); 20.8% and 11.1% of these pts remained on T-DXd and TPC for >12 mo, respectively. IC response data are shown in the table. Median IC PFS by BICR for T-DXd was 9.7 mo (95% CI, 4.4-15.1 mo) vs not evaluable for TPC, due to small pt numbers. In this exploratory analysis, IC responses favored T-DXd over TPC in pts with clinically stable and treated baseline BMs. While only a small number of pts were included here, the IC efficacy data suggest a clinical benefit of T-DXd over TPC.Table: 388PSummary of intracranial responsesT-DXd n = 24TPC n = 11Intracranial confirmed ORR (CR + PR), n (%) [95% CI]a6 (25.0) [9.8-46.7]0 [0-28.5]Best overall intracranial response, n (%) CR4 (16.7)0 PR2 (8.3)0 SD12 (50.0)7 (63.6) PD01 (9.1) NE1 (4.2)0Missingb5 (20.8)3 (27.3)Clinical benefit rate (CR + PR + (>6 mo) SD), n (%) [95% CI]a14 (58.3) [36.6-77.9]2 (18.2) [2.3-51.8]Disease control rate (CR + PR + SD), n (%) [95% CI]a18 (75.0) [53.3-90.2]7 (63.6) [30.8-89.1]CR, complete response; NE, not evaluable; PD, progressive disease; PR, partial response; SD, stable disease. aBased on Clopper-Pearson method for single proportion. bImaging not performed/available. Open table in a new tab

1064 Background: In 11.2018, the PIK3CA-inhibitor alpelisib was made available in France through an early access program (EAP), in combination with fulvestrant in pre-treated PIK3CA-mutant, HR-positive, HER2-negative advanced breast cancer (ABC) patients. Patients had to received two or more prior systemic treatments for ABC, including an aromatase inhibitor and a CDK4/6 inhibitor in the absence of contraindications. This retrospective real-life, EAP-based study aimed to assess the efficacy and safety of alpelisib/fulvestrant combination in the post CDK4/6 inhibitor setting. Methods: The IRB-approved protocol and call for data were sent on 10.2020 to the cancer centers which participated the most in the EAP prospective registry. Eligible patients were women who started alpelisib/fulvestrant between 11. 2018 and 10.2020 as part of the EAP (which excluded patients with visceral crisis or inflammatory BC). Alpelisib and fulvestrant were used at standard doses. Primary endpoint was PFS by local investigators using RECIST1.1. Secondary endpoints included objective response rate and safety (NCI CTCAE v5.0). Results: 10 centers provided individual data regarding 209 consecutive patients. Patients had received a median number of 4 (1-14) previous systemic treatments for ABC, including CDK4/6 inhibitors, chemotherapy, fulvestrant (alone or in combination) and everolimus for 206 (98.8%), 159 (76.1%), 163 (78%) and 123 (58.8%) patients, respectively. With a median FU of 7.0 months, median PFS was 4.0 months (95%CI [3.5;5.0]) and 35.4% of 164 evaluable patients had an objective response. After stratification on the number of prior lines of treatment, prior exposure to everolimus had no impact on PFS (mPFS in the 123 patients pretreated with everolimus: 4.0m, 95%CI [3.5-5.5]). Of note, this population was enriched in patients who had a long disease control by everolimus (median time spent on everolimus: 7.0m, range (6.5-9.0)). In multivariable analysis, characteristics significantly associated with longer PFS were PS < 3 (HR = 0.03, 95%CI [0.02-0.29]) and prior treatment with fulvestrant (HR = 0.53, 95%CI [0.32-0.89]). N = 81(38.8%) patients discontinued alpelisib due to adverse events (AEs). Most frequent grade 3/4 AEs were hyperglycemia, skin rash, diarrhea and fatigue occurring in 13.4, 8.1, 4.8 and 1.9 % of patients, respectively. Conclusions: Despite heavy pre-treatments, alpelisib +fulvestrant had a clinically relevant efficacy in the French EAP population. Interestingly, prior treatment with either everolimus or fulvestrant did not overtly impair alpelisib-fulvestrant efficacy. The best treatment sequence for PI3KCA/mTOR inhibitors could be examined in future trials in PIK3CA-mutant ER+/HER2- ABC patients.

BACKGROUND:Neurokinin (NK) 1 receptor antagonists (RAs), administered in combination with a 5-hydroxytryptamine-3 (5-HT3 ) RA and dexamethasone (DEX), have demonstrated clear improvements in chemotherapy-induced nausea and vomiting (CINV) prevention over a 5-HT3 RA plus DEX. However, studies comparing the NK1 RAs in the class are lacking. A fixed combination of a highly selective NK1 RA, netupitant, and the 5-HT3 RA, palonosetron (NEPA), simultaneously targets two critical antiemetic pathways, thereby offering a simple convenient antiemetic with long-lasting protection from CINV. This study is the first head-to-head NK1 RA comparative study in patients receiving anthracycline cyclophosphamide (AC) and non-AC moderately emetogenic chemotherapy (MEC). MATERIALS AND METHODS:This was a pragmatic, multicenter, randomized, single-cycle, open-label, prospective study designed to demonstrate noninferiority of single-dose NEPA to a 3-day aprepitant regimen in preventing CINV in chemotherapy-naive patients receiving AC/non-AC MEC in a real-life setting. The primary efficacy endpoint was complete response (no emesis/no rescue) during the overall (0-120 hour) phase. Noninferiority was achieved if the lower limit of the 95% confidence interval (CI) of the difference between NEPA and the aprepitant group was greater than the noninferiority margin set at -10%. RESULTS:Noninferiority of NEPA versus aprepitant was demonstrated (risk difference 9.2%; 95% CI, -2.3% to 20.7%); the overall complete response rate was numerically higher for NEPA (64.9%) than aprepitant (54.1%). Secondary endpoints also revealed numerically higher rates for NEPA than aprepitant. CONCLUSION:This pragmatic study in patients with cancer receiving AC and non-AC MEC revealed that a single dose of oral NEPA plus DEX was at least as effective as a 3-day aprepitant regimen, with indication of a potential efficacy benefit for NEPA. IMPLICATIONS FOR PRACTICE:In the absence of comparative neurokinin 1 (NK1 ) receptor antagonist (RA) studies, guideline committees and clinicians consider NK1 RA agents to be interchangeable and equivalent. This is the first head-to-head study comparing one NK1 RA (oral netupitant/palonosetron [NEPA]) versus another (aprepitant) in patients receiving anthracycline cyclophosphamide (AC) and non-AC moderately emetogenic chemotherapy. Noninferiority of NEPA versus the aprepitant regimen was demonstrated; the overall complete response (no emesis and no rescue use) rate was numerically higher for NEPA (65%) than aprepitant (54%). As a single-dose combination antiemetic, NEPA not only simplifies dosing but may offer a potential efficacy benefit over the current standard-of-care.

In this first head-to-head neurokinin (NK) 1 receptor antagonist (RA) comparative study in patients receiving anthracycline cyclophosphamide (AC) and non-AC MEC, a single dose of NEPA (fixed combination NK1RA, netupitant, and 5-HT3RA, palonosetron) was non-inferior to a 3-day aprepitant (APR) regimen in preventing CINV. The overall (0-120 h) complete response (CR; no emesis, no rescue) rates were 65% NEPA vs 54% APR. While chemotherapy emetogenicity may be the primary consideration when choosing antiemetics, it is established that patient factors also play a role in determining emetic risk. For patients receiving non-AC MEC, antiemetic guidelines recommend an NK1RA regimen for those receiving carboplatin or those with additional patient-related risk factors. In this post-hoc analysis, we evaluated the subgroup of patients receiving non-AC MEC who had ≥1 patient-related emetic risk factor. This subgroup was from a pragmatic, multicenter, randomized, prospective study. Oral NEPA was administered as a single dose on day 1, while APR was given on days 1-3 + ondansetron on day 1; all patients were to receive dexamethasone on days 1-4. Chemotherapy-naïve patients included were those receiving non-AC MEC and either female, male <60 years, male ≥60 years who received carboplatin, or male ≥60 years with anxiety. CR rates were compared between groups during the acute (0-24 h), delayed (25-120 h) and overall (0-120 h) phases. Of all patients (n = 211) in the non-AC MEC subgroup, 181 (86%) were included in this risk factor subset. Significantly higher CR rates were seen for NEPA during both the acute and overall phases.Table: 1672PComplete Response RatesNEPA (N = 92)Aprepitant Regimen (N = 89)P-ValueAcute85.9%74.2%0.05Delayed88.0%84.3%0.46Overall73.9%58.4%0.03 Open table in a new tab A single dose of NEPA, administered on day 1 only, was shown to be more effective that a 3-day APR regimen in preventing CINV following non-AC MEC in patients with emetic risk factors.

OBJECTIVES:Febrile neutropenia (FN) commonly occurs during cancer chemotherapy. Prophylaxis with granulocyte colony-stimulating factors (G-CSFs) is known to reduce the severity and incidence of FN and infections in patients with cancer. Despite the proven efficacy, G-CSFs are not always prescribed as recommended. We performed a discrete-choice experiment (DCE) to determine what factors drive the physician preference for FN prophylaxis in patients with cancer undergoing chemotherapy. METHODS:Attributes for the DCE were selected based on literature search and on expert focus group discussions and comprised pain at the injection site, presence of bone pain, associated fever/influenza syndrome, efficacy of prophylaxis, biosimilar availability, number of injections per chemotherapy cycle and cost. Oncologists, in a national database, were solicited to participate in an online DCE. The study collected the responses to the choice scenarios, the oncologist characteristics and their usual prescriptions of G-CSFs in the context of breast, lungs and gastrointestinal cancers. RESULTS:Overall, the responses from 205 physicians were analysed. The physicians were mainly male (61%), with ≤20 years of experience (76%) and working only in public hospitals (73%). The physicians prescribe G-CSF primary prophylaxis for 32% of patients: filgrastim in 46% and pegfilgrastim in 54%. The choice of G-CSF for primary and secondary prophylaxis was driven by cost and number of injections. Biosimilars were well accepted. CONCLUSION:Cost and convenience of G-CSF drive the physician decision to prescribe or not G-CSF for primary and secondary FN prophylaxes. It is important that these results be incorporated in the optimisation of G-CSF prescription in the clinical setting.

While iron deficiency (ID) in cancer patients is frequent, it is likely under-diagnosed and under-treated, in particular in patients without anaemia or at an early stage of the disease. Also, ID diagnosis is rarely based on the transferrin coefficient saturation (TSAT) which is very sensitive in patients with inflammatory diseases. We previously showed that ID was frequent in patients under metastatic treatment. Here, we aimed to assess the prevalence of ID based on TSAT index in cancer patients treated at an early stage of the disease. This is a post hoc analysis using data collected during the CARENFER study which was conducted in 15 oncology units in France in 2019. All patients present in the medical unit during the study period, regardless of the type of tumour, were eligible. Both serum ferritin and TSAT index were measured in all included patients. The prevalence of TSAT<20% was computed in two subgroups of patients receiving early treatment of the disease: either adjuvant or neo-adjuvant treatment. A total of 443 patients with a documented curative treatment were analysed: 300 (67.7%) received an adjuvant treatment and 143 (32.3%) a neo-adjuvant treatment, consisting in chemotherapy in most cases. TSAT<20% was found in 47.1% (41.5-52.8) of patients with adjuvant treatment and 51.0% (42.9-59.1) of patients with neo-adjuvant treatment. Among iron-deficient patients according to ESMO definition (based on both ferritin level and TSAT), 85.8% and 90.1% of patients had a TSAT <20%, in the two treatment groups respectively. The prevalence of ID in cancer patients receiving adjuvant or neo-adjuvant treatment was high, and of the same magnitude than that reported in patients under metastatic treatment. Early diagnosis and treatment of ID in those patients at early-stage disease might limit the occurrence of anaemia and improve quality of life. TSAT < 20% as the sole criterion for defining ID had a high sensitivity and might be considered for ID diagnosis.

Objective Over recent decades, supportive care and patient quality of life, advocated by dedicated guidelines, have become a core focus of the concept of integrative medicine. The Calista 2 survey was conducted in France between September 2016 and October 2017 among oncologists and their patients being treated for early breast cancer, adjuvant colorectal cancer or advanced lung cancer. The present analysis sought to ascertain, understand and rank the expectations of cancer patients with regard to supportive care. Methods Data were collected from 467 questionnaires from patients recruited by 82 oncologists. Inclusion criteria were patients already on treatment for breast cancer, colorectal cancer or lung cancer. Most supportive care facilities were available at the point of care. Results Physicians were mainly seen to offer management of adverse events (81%), and pain (72%), psychological support (56%), and advice on diet/nutrition (49%). Patient uptake of supportive care related essentially to management of adverse events (72%) and pain (61%), diet/nutrition (34%), and self-image improvement techniques (31%). The main unmet needs voiced by patients were information on complementary medicines (28%), management of fatigue (27%), and relaxation techniques (24%). Conclusion Supportive care was essentially seen to satisfy patient requirements with regard to the management of adverse events and pain. However, patients highlighted the need for a wider access to fatigue management and information on complementary medicine and relaxation techniques.

Olaparib was initially approved by the European Medicines Agency (EMA) as maintenance treatment for pts with BRCAm platinum-sensitive relapsed high-grade EOC, following the results of a randomized phase II trial (study 19). The RETROLA study aimed to evaluate whether the outcome observed in this clinical trial are reflected in routine clinical practice, in a real-world cohort of pts. We planned to include 130 pts in this retrospective cohort. French centers (n=28) representative of French regions and of mode of practice were asked to participate. Overall, 251 pts were identified. At each center, up to 6 pts who started olaparib (400 mg bid, capsule formulation) between 03/2014 and 03/2017 were randomly selected and included. Medical records were reviewed for clinic and pathologic characteristics, survival outcomes and safety. Our primary objective was to assess efficacy of olaparib in real-world pts treated upon initial EMA label (ptsEMA) by evaluating progression free survival (PFS) from olaparib initiation. Overall, 128 pts were included in the analysis and 89 were treated according to EMA label. Main reasons to be given olaparib off-label were absence of radiological response following platinum-based chemotherapy (n=22) and non high-grade serous EOC subtype (n=14). BRCA1/2 mutation was present in 126 pts (98%). Most pts (68%) received olaparib after 3 or more lines of platinum-based chemotherapy. Median follow up was 41.8 months. Median PFS in ptsEMA was 17.0 months (95% CI: 14.7-21.3). Median PFS and overall survival (OS) in the whole population were 15.5 months (95% CI: 12.6-18.1) and 33.6 months (95% CI: 28.7; 40.3), respectively. Fourteen (11.2%) pts stopped olaparib for toxicity reason and 75 (58.6%) had at least one dose reduction or one dose interruption. Related myelodysplastic syndrome and second cancers were diagnosed in respectively n=5 and n=1 pts. Number of previous lines of systemic therapy ≤2 was associated with prolonged PFS. With an extended follow-up, efficacy and toxicity of olaparib in real-world cohort of pts are consistent with findings observed in study 19 and SOLO-2 trials.

Abstract Background Comprehensive cancer care uses complementary approaches alongside specific anticancer therapy. Using a dedicated questionnaire, the Calista 2 national survey sought to assess the importance of supportive care and activities among breast cancer (BC) patients, how often these services are made available, the uptake rate, and the proportion of unmet needs. Methods Of the 82 physicians who accepted to take part in the survey, 29 recruited 257 patients with BC of whom 210 answered the patient-reported questionnaire. Patients meeting the inclusion criteria were adult females already on specific therapy for early or advanced BC. The patient-reported questionnaires covered drug management of pain, fatigue, adverse events (AE), sleep disorders, social and psychological support, physical activities, and complementary and alternative medicines. Items were rated on a scale of 0 – 10. Questionnaires were collected between September 2016 and October 2017. Results After exclusion of non-valid patient questionnaires, 197 were analyzed. The mean age of these patients was 56.8 years (SD 12.6); 53% had early stage disease and 41% advanced stage disease. Patients perceived the management of AE and pain, and self-image improvement techniques as the three most important items (8.0, 7.5, 6.7, respectively), followed by physical activity (6.3) and the management of fatigue (6.0), while preservation of fertility (2.3), spiritual support (2.5), counselling with regards to employment (3.2), and art therapy (3.3) were the least important. Most facilities were available at the point of care. Physicians frequently suggested management AE and pain (83% and 73%, respectively), self-image improvement techniques (73%) and psychological support for the patient (70%). Management of fatigue was however far less frequently proposed (30%). Management of AE (75%) and pain (60%), and self-image improvement (50%) were the most widely used support techniques. Only 19% of patients who were offered support in the management of fatigue declared actually using it. The management of fatigue nevertheless represented one of the three main unmet needs (for 27% of patients), together with complementary medicines (37%) and relaxation (29%). Conclusion These key findings highlight the fact that support for the management of AE and pain, together with self-image improvement techniques, are important for patients, are available, suggested and used. Although management of fatigue is available, it is rarely suggested by physicians and is therefore seen by patients as an unmet need. Patients also expressed the need for complementary medicines and relaxation techniques; these are however less frequently available at the point of care and seldom proposed. Citation Format: Simon H, Viguier J, Naman H, Touboul C, Lhomel C, Ganem G, Eisinger F, Morère J-F. Patient care in breast cancer: Unmet and fulfilled needs [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-23.

1043 Background: For ER+/HER2- metastatic breast cancer (mBC), efficacy of endocrine therapy + chemotherapy combination remain an open question. We hypothesized that continuing ER targeted therapy after progression in combination with chemotherapy may improve disease control. The objective of the CHEOPS trial was to assess the benefit of adding aromatase inhibitor (AI) to metronomic chemotherapy,oral vinorelbine, 50mg/3 time a week (OV) for AI pre-treated, ER+/HER2- mBC patients. Methods: Eligible patients had to have progressed on endocrine therapy and one or two lines of chemotherapy. They were randomized between vinorelbine (OV) and vinorelbine + AI (OV+AI). Primary end point was progression-free survival (PFS). To show an increase of median PFS (from 3.5 to 5.5 month, HR 0.636), with alpha = 5% and power = 80%, 130 evaluable patients were needed. Results: 121 patients were Included (OV = 61; OV+AI = 60). Median age was 68 (range: 49-87), Median time from metastatic diagnosis was 3.2 years (range 0 - 16.9). 109 patients (90%) had visceral metastases. They all had previously received an AI and had been treated with one line (N = 66, 54.5%), or 2 lines (N = 55, 45.5%) of chemotherapy. Median PFS was increased from 2.3 months with OV to 3.7 months with OV+AI, but this difference was not significant (HR 0.73 [95 % CI 0.50-1.06], log-rank test: P = 0.09) 81 patients (67%) had at least one adverse event (AE) of grade ≥ 3 (40 (66%) for OV vs 41 (68%) for OV+AI). The most common grade ≥ 3 AE were: GT gammas (23%), neutropenia (18%), arterial hypertension and lymphopenia (17%). The occurrence of 3 toxic deaths (OV = 1; OV+AI = 2) secondary to febrile aplasia motivated the early cessation of this clinical trial. 9 patients (5 OV (10%) and 4 OV+AI (8%) presented an objective complete or partial response. Conclusions: The addition of AI to OV over OV alone in AI resistant mBC was associated with a non-significant improvement of PFS, but both PFS are lower than expected. Metronomic OV schedule, at 50 mg three times a week, requires close biological monitoring. The question of hormonal treatment and chemotherapy combination remains open. Clinical trial information: EudraCT Number: 2015-000401-39.

La prise en charge du cancer, au-delà des traitements, intègre aujourd'hui des solutions en matière de soins/activités de support. L'enquête Calista 2 a cherché à identifier et analyser les attentes des patients dans ce domaine. L'enquête a été menée auprès d'un échantillon national représentatif de médecins oncologues médicaux et de spécialistes d'organes exerçant à l'hôpital ou en clinique privée et de patients en cours de traitement pour un cancer. Un auto-questionnaire destiné aux patients portait sur la prise en charge médicamenteuse de la douleur, des effets indésirables (EI), de la fatigue et des troubles du sommeil, le soutien psychologique et social, l'activité physique ainsi que les médecines complémentaires. Les questionnaires ont été recueillis entre septembre 2016 et octobre 2017. Cette analyse montre que la douleur et les EI sont pris en charge correctement, au contraire de la fatigue, du soutien psychologique pour les proches, qui sont disponibles mais non utilisés ; ou de l'accès aux médecines complémentaires et à des pratiques de relaxation, rarement disponibles.

Purpose: This study aimed to compare the self-reported perceptions of the repercussions of the disease and its treatments and emotional distress in young women with breast cancer and their partners. Design: Cross-sectional study using self-reported questionnaires. Sample: 491 couples in which women were aged Methods: Patients and partners completed a questionnaire assessing their self-reported perceptions of the disease and treatments (Patient YW-BCI and Partner YW-BCI for the partners) and their emotional distress (CESD; STAI). Findings: Patients reported more difficulties than partners in the management of child(ren) and everyday life, body image and sexuality, negative affectivity about the disease and apprehension about the future, career management, and finances. While the difficulties were generally more marked in the chemotherapy and Trastuzumab groups than in the hormone therapy and follow-up groups, the negative affectivity about the disease and apprehension about the future was high in all four groups, especially in patients. The partners reported more difficulties in sharing with close relatives, and even more in those groups reflecting the latest treatment phases. No difference appeared between patients and partners in couple cohesion and deterioration of relationships with relatives. Partners were less anxious than patients but as depressed as them. Conclusions: Difficulties of patients and partners seem particularly severe in the early care pathway, maybe reflecting better adjustment in women under surveillance and their partners. A longitudinal study will substantiate this finding and enable a better identification of some explanatory processes of these differences and similarities in the daily self-reported repercussions of the disease throughout the cancer care pathway. Implications for psychosocial oncology: It seems important to support young women with breast cancer and their partners, as our results evidence distress in both and differences according to the type of treatment the woman is currently receiving. Healthcare providers need consistent methods to identify and respond to couples' distress and reduce significant disparities in support.

e18821 Background: In addition to increasing treatment efficacy and reducing adverse effects, appropriate supportive care can improve patient quality of life. The Calista2 survey sought to identify, understand and rank the expectations of cancer patients with regard to supportive care and activities. Methods: The 82 physicians who took part in the survey recruited 666 patients; all were already on specific therapy for breast cancer (BC), colorectal cancer (CRC) or lung cancer (LC). Patient questionnaires (collected September 2016-October 2017) were self-reported. Questions covered various types of patient care. Our analysis focused on virtual maximum use (VMU) of a given type of supportive care, defined as the sum of its actual rate of use and the percentage of patients interested (currently non-users). VMU helps determine the demand for such support and provides useful data on how best to supply appropriate services. Results: After exclusion of non-valid questionnaires, 467 were analyzed. All cancer localizations combined, drug management of adverse effects (78%), pain (64%), diet/nutrition (51%) and fatigue (49%) were seen to be in greatest demand. Complementary medicine, physical activity and relaxation techniques were in lower demand (VMU: 46%, 42%, 36%, respectively). Few patients requested spiritual support (14%), support from the workplace (14%), or group discussion for children (14%). VMU is influenced by cancer localization, i.e., sleep disorder management was more important for LC and BC patients (46% LC and 43% BC vs 29% CRC, P < 0.05), as was improving self-image for BC patients (62% vs 32% CRC and 31% LC, P < 0.05). We also observed differences according to gender (relaxation techniques were more in demand for women than men, 44% vs. 22%, P < 0.05), and age (adverse effect management was more often requested by patients ≤60 yrs than > 60 yrs, 83% vs 73%, P < 0.05). Conclusions: Although medical supportive care is the most sought-after, patients also seek the support of non-medical interventions. Certain care procedures that are typically in very low demand may however prove crucial in specific situations. Our findings may help healthcare providers build a comprehensive offer of patient care to meet the expectations and needs of their patients.