Development and Evaluation of a Remote Monitoring Regional Adjuvant Abemaciclib Service for Patients With High-Risk Early Breast Cancer

Introduction: Adjuvant abemaciclib was recently approved in high-risk early breast cancer, leading to an increase in oncology resource utilisation. We thus developed a regional, remote monitoring clinical service. The set-up, delivery processes and outcomes from the first 6 months' consecutive patients are presented.

Methods: A regional delivery model with remote monitoring using optional electronic patient outcome measures (ePROMs) and bloods closer to home (BCTH) was implemented. Electronic patient records of patients entering the service (October 31, 2022 to May 31, 2023) were reviewed. Time-in-motion and on-line patient satisfaction surveys were conducted with questions adapted from prior questionnaires used by our cancer center. An independent t-test was used to assess differences in creatinine levels whilst on abemaciclib and a Mann-Whitney test to determine whether the time taken to complete follow-up appointments differed with and without ePROMs.

Results: The first 103 patients to commence abemaciclib (median age 58 [range, 27-85], 66.0% White) had completed a median of 6 cycles (range, 0-9). 51.5% had treatment interruption, 52.4% a dose reduction and 15.5% discontinued therapy. Diarrhoea (90.3%), fatigue (84.9%) and anorexia (73.1%) were the most commonly reported toxicities on ePROMs. 10.8% of patients reported grade 3-4 toxicities. Neutropenia was also common and low grade. 89.5% of patients would recommend ePROMs and 98.0% found the BCTH service easy to use. Review appointments with ePROMs were a similar length to those without (P = .138).

Conclusions: We have successfully implemented a remote, regional adjuvant clinical service which could serve as a blueprint for other NHS trusts for this and other cancer drugs.