Perceptions, Experiences, and Behaviors of Patients and Their Caregivers With Gastric and Gastroesophageal Cancer Treated With or Without Trastuzumab Deruxtecan (T-DXd) in the United States

OBJECTIVES: The benefits of trastuzumab deruxtecan (T-DXd) in HER2+ gastric cancer (GC) or gastroesophageal junction cancer (GEJC) depends upon many factors, including prescriber and patient awareness of and close adherence to treatment regimens. We sought to better understand patient/caregiver perspectives related to their disease and its treatment among T-DXd and non-T-DXd users.

METHODS: We conducted three focus groups among a total of 23 GC/GEJC patients and/or caregivers. Focus groups were conducted as two-hour, recorded, virtual meetings with live polls and a guided discussion about patients’/caregivers’ journeys with GC/GEJC. A thematic analysis approach was used to identify key themes across groups.

RESULTS: Patients were between 29-81 y/o with an average age of 54 y/o, 55% (n=11) female and 45% (n=9) male, 75% (n=15) White, 10% (n=2) Asian, 10% (n=2) Hispanic, and 5% (n=1) Black/African American. Seventy-five percent of patients (n=15) had locally advanced/metastatic GC/GEJC. Four patients received T-DXd. Most non-T-DXd users felt they did not receive adequate information from prescribers at diagnosis about GC/GEJC, biomarkers, or treatment options, but most T-DXd users did not feel this way. Most bothersome adverse effects (AEs) reported while on GC/GEJC treatment varied by disease stage; early-stage patients mentioned gastrointestinal effects (nausea/vomiting, dumping syndrome, difficulty maintaining weight) as most impactful, while late-stage patients noted pain and fatigue. While patients would have liked more information upfront about treatment-emergent AEs, most were reportedly willing to tolerate almost any AE for effective treatment.

CONCLUSIONS: There is a need to increase awareness of GC/GEJC among both patients and health care providers (HCPs) so cases can be identified in the early stages of the disease. Future communication strategies should focus on increasing disease awareness and facilitating early conversations between patients and HCPs. Resources should include information about subtle/early GC/GEJC symptoms, biomarker testing, treatment options, potential treatment AEs, and AE management strategies.