title: Enhancing accrual to chemotherapy trials for patients with early stage triple-negative breast cancer: a survey of physicians and patients.
abstract: The optimal chemotherapy regimen for patients with early stage triple-negative breast cancer (TNBC) remains unknown. The purpose of the study is to survey physicians and breast cancer patients about preferred chemotherapy regimens for early stage TNBC and clinical trial strategies.
  
  
  
  A standardised online questionnaire was developed and circulated to medical oncologists known to treat breast cancer. A separate questionnaire was given to patients who had received chemotherapy for breast cancer.
  
  
  
  The questionnaire was completed by 41/84 medical oncologists (48.8% response rate) and 74 patients. The most commonly used neoadjuvant and adjuvant chemotherapy regimens for TNBC were dose-dense doxorubicin and cyclophosphamide (AC)-paclitaxel (P), dose-dense AC followed by weekly P and fluorouracil, epirubicin, cyclophosphamide-docetaxel (FEC-D). The majority of medical oncologists (80%) would be willing to enrol patients in trials evaluating the most effective chemotherapy regimen for TNBC. Oncologists favoured a three arm trial design comparing currently available standard of care treatments (36%) and trials of novel or non-standard of care agents 22% (9/41). Sixty percent (41/74) of patients indicated that they would be willing to be enrolled in trials evaluating various adjuvant regimens for TNBC. Both oncologists and patients were interested in novel consent approaches such as using the integrated consent model.
  
  
  
  Optimisation of chemotherapy for TNBC is an important and unmet clinical need. It is apparent that various chemotherapy regimens are used for patients with early stage TNBC. The majority of medical oncologists and patients are interested in entering trials to optimise chemotherapy choices.
authors.affiliation: Public Health and Preventative Medicine, University of Ottawa School of Epidemiology, Ottawa, Canada.|Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Carmel
authors.initials: C
authors.lastname: Jacobs
authors.affiliation: Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada.|The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.|Public Health and Preventative Medicine, University of Ottawa School of Epidemiology, Ottawa, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Clemons
authors.affiliation: The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Sasha
authors.initials: S
authors.lastname: Mazzarello
authors.affiliation: Public Health and Preventative Medicine, University of Ottawa School of Epidemiology, Ottawa, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Hutton
authors.affiliation: Division of Medical Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada.
authors.forename: Anil A
authors.initials: AA
authors.lastname: Joy
authors.affiliation: London Health Sciences Centre, London, Canada.
authors.forename: Muriel
authors.initials: M
authors.lastname: Brackstone
authors.affiliation: Durham Regional Cancer Centre, Oshawa, Canada.
authors.forename: Orit
authors.initials: O
authors.lastname: Freedman
authors.affiliation: The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Vandermeer
authors.affiliation: Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.|Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Dean
authors.initials: D
authors.lastname: Fergusson
authors.affiliation: Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada. jfhilton@toh.ca.|The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. jfhilton@toh.ca.
authors.forename: John
authors.initials: J
authors.lastname: Hilton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010361:Patients; D010820:Physicians; D011795:Surveys and Questionnaires; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy*
keywords: Breast cancer; Chemotherapy; Trial design; Triple negative