A real-world data analysis presented at the 2024 San Antonio Breast Cancer Symposium (SABCS) reveals a significantly lower incidence of interstitial lung disease (ILD) among patients with HER2-positive (HER2+) breast cancer. The study, named Project EVOLVE, observed an ILD incidence of 4.17%, contrasting with the 10% to 14% previously reported in published literature.
The study demonstrated that integrating artificial intelligence (AI)-powered health record analytics with targeted educational interventions improved ILD management and enhanced patient and healthcare provider outcomes. This approach offers a promising model for addressing complex adverse events in oncology, paving the way for more personalized and effective cancer care strategies that prioritize patient safety and treatment efficacy.
Impact of HER2-Targeted Therapies and ILD
HER2-targeted therapies, including trastuzumab (Herceptin) and fam-trastuzumab deruxtecan-nxki (Enhertu), have significantly improved survival rates for HER2+ breast cancer patients. However, these therapies are associated with ILD, a rare but serious adverse event requiring careful monitoring and management. While established guidelines for ILD treatment exist, real-world recognition and management pose challenges.
The real-world data analysis phase of Project EVOLVE encompassed over 500,000 patient records. The 4.17% ILD incidence among respiratory adverse events was notably lower than rates reported in prior clinical trials. Other respiratory adverse events observed included asthma (37.5%), the common cold (20.8%), and COVID-19 (8.3%).
Educational Intervention and Improved Confidence
Following the educational intervention, healthcare providers reported significant improvements in their ability to manage HER2+ breast cancer treatment and associated adverse events. Confidence in managing ILD and other respiratory adverse events increased from 66% to 90%. The ability to correctly identify ILD as a boxed warning for trastuzumab deruxtecan improved from 19% to 47%. Providers also reported greater confidence in tailoring treatment plans to individual patient needs.
Patients also benefited from the education, with confidence in adhering to treatment and managing adverse events at home increasing from 55% to 79%. Over half of the patients surveyed (53%) cited the educational modules as instrumental in helping them better understand their condition, treatment options, and side effect management.
The lower ILD incidence observed in this study underscores the value of real-world data in providing unique insights that differ from those seen in clinical trials, potentially reshaping adverse event monitoring protocols. This data-driven education model offers a scalable, practical approach to managing serious adverse events among patients with cancer, demonstrating that as personalized care advances, AI and targeted education can enhance patient outcomes.
